final study guide

Your client has a diagnosis of hypervolemia. What would be an important intervention that you would initiate? limit sodium and water intake teach client behaviors that decrease urination give medication that promote fluid retention assess for dehydration

limit sodium and water intake

Which symptoms are indicators that the client is having an anaphylactic reaction? (Select all that apply.) panicked feeling bradycardia nausea hives difficulty breathing

panicked feeling hives difficulty breathing

A patient admitted with inflammatory bowel disease asks the nurse for help with menu selections. What menu selection is most likely the best choice for this patient? multigrain bagel blueberries tofu spinach

tofu

Autism spectrum disorder is characterized by: Wide variation in behavior and sensory needs Different Social/Communication Skills (T/F)

true

The nurse is doing discharge teaching with a patient who has coronary artery disease. The patient asks why he has to take an aspirin every day if he doesn't have any pain. What would be the nurse's best response? "An aspirin a day eventually helps your blood carry more oxygen that it would otherwise." "Taking an aspirin every day is a simple way to make your blood penetrate your heart more freely." "Taking an aspirin every day is an easy way to help restore the normal function of your heart." "An aspirin a day can help prevent some of the blockages that can cause chest pain or heart attacks."

"An aspirin a day can help prevent some of the blockages that can cause chest pain or heart attacks."

A nursing student is taking a pathophysiology examination. Which of the following factors would the student correctly identify as contributing to the underlying pathophysiology of chronic obstructive pulmonary disease (COPD)? Choose all that apply. -Mucus secretions that block airways -Decreased numbers of goblet cells -Overinflated alveoli that impair gas exchange -Dry airways that obstruct airflow -Inflamed airways that obstruct airflow

-Mucus secretions that block airways -Overinflated alveoli that impair gas exchange -Inflamed airways that obstruct airflow

You are giving furosemide 60 mg IV now for hypertension. The label reads 80 mg/ml. How many l will you give? Round to the nearest tenth. 8 ml 0.8 ml 4 ml 6.8 ml

0.8mL

A patient is 2 hours postoperative with a Foley catheter in situ. The last hourly urine output recorded for this patient was 10 mL. The tubing of the Foley is patent. What should the nurse do? Notify the physician and continue to monitor the hourly urine output closely. Have the patient sit in high-Fowler's position. Irrigate the Foley with 30 mL normal saline. Decrease the IV fluid rate and massage the patient's abdomen.

Notify the physician and continue to monitor the hourly urine output closely.

You have the following order: Administer Cefazolin 1 gm every 6 hrs. Cefazolin 1gm comes in D5W 50 ml. You are planning to infuse the dose in 30 minutes. What is your rate of infusion-ml/hr? 30 ml/hr 100 ml/hr 200 ml/hr 50 ml/hr

100mL/hr

You are to give potassium chloride 15 mEq po q 12 hrs. The label reads 20 mEq/15 ml. How many ml will you give per dose? Round to nearest tenth. 11.3 ml 18.3 ml 15 ml 30 ml

11.3 mL

A medical nurse is caring for a patient with type 1 diabetes. The patient's medication administration record includes the administration of regular insulin three times daily. Knowing that the patient's lunch tray will arrive at 11:45, when should the nurse administer the patient's insulin? 11:45 11:50 10:45 11:15

11:15

You are a nurse caring for a 45-year-old patient has had Type 2 Diabetes for 5 years. His current diet consists of high-fat and high-carbohydrate foods, high sodium intake, and minimal vegetable consumption. He does not exercise and has smoked one pack of cigarettes a day since his early 20s. Generate an education plan for this patient. Identify immediate and long-term goals of management for his diabetes. Identify community resources that may be useful to this patient.

1. Generate an education plan for this patient. Identify immediate and long-term goals of management for his diabetes. Diabetes is a chronic illness that requires a lifetime of special self-management behaviors. Many things affect how patients control diabetes such as medical nutrition therapy (MNT), physical activity, medication, as well as physical and emotional stress. Patients should learn how to balance these things as well as a multitude of other possible factors. One approach is to organize education using the seven tips for managing diabetes identified and developed by the American Association of Diabetes Educators: healthy eating, being active, monitoring, taking medication, problem solving, healthy coping, and reducing risks. Another general approach is to organize information and skills into two main categories: basic, initial, or "survival" skills and information; and in-depth (advanced) or continuing education. Developing an education plan for a patient newly diagnosed with type 2 diabetes would begin with a learning needs assessment, as well as a discussion regarding the patient's questions and concerns. "Survival" education would need to focus on the disease process and pharmacologic treatment strategies. Demonstration-return demonstration would be involved in the education plan for self-monitoring of blood glucose and insulin use, if applicable. His current diet, lack of exercise, and smoking would be essential areas for lifestyle modification. Continuing education would involve meal planning, fitness, stress management, and smoking cessation. The nurse could partner with the patient on the area(s) he is willing to address first, then provide education in written and verbal formats for the patient. Immediate goals for this patient with diabetes would include routine glucose monitoring, adherence to the treatment regimen, and blood glucose levels in recommended ranges to prevent or stop diabetes-related complications. Ideally, long-term goals would include adjusting his diet to be low fat/carbohydrate/sodium, adopt a consistent exercise routine, lose weight, and stop smoking. 2. Identify community resources that may be useful to this patient. Community health workers, public health department, certified diabetic educators, home health agency, hospital-based diabetes education.

A patient has had an ileostomy created for the treatment of irritable bowel disease and the patient is now preparing for discharge. What should the patient be taught about changing this device in the home setting? Apply antibiotic ointment as ordered after cleaning the stoma Apply a skin barrier to the peristomal skin prior to applying the pouch. Dispose of the clamp with each bag change. Cleanse the area surrounding the stoma with alcohol or chlorhexidine.

Apply a skin barrier to the peristomal skin prior to applying the pouch.

Your patient is to receive ampicillin 0.5 gram po q 6 hrs for treatment of pneumonia. The capsules are 250 mg. How many capsules will you administer per dose? 2 capsules 5 capsules 4 capsules 1.5 capsule

2 capsules

Your patient is receiving postoperative morphine through a patient-controlled analgesic (PCA) pump and the patient's orders specify an initial bolus dose. What is your priority assessment? Assessment for respiratory depression Assessment for paradoxical increase in pain Assessment for fluid overload Assessment for decreased level of consciousness (LOC)

Assessment for respiratory depression

A child with a diagnosis of Down syndrome has which chromosomal abnormality? 1 copy of the chromosome 8 has occurred instead of 2 copies. 3 copies of trisomy 21 has occurred instead of 2 copies. 3 copies of trisomy 18 has occurred instead of 2 copies. 3 copies of trisomy 13 has occurred instead of 2 copies.

3 copies of trisomy 21 has occurred instead of 2 copies.

A patient with hypertension is waking up several times a night to urinate. The nurse knows that what laboratory studies may indicate pathologic changes in the kidneys due to the hypertension? (Select all that apply.) Blood urea nitrogen (BUN) AST and ALT Complete blood count (CBC) Creatinine Urine for culture and sensitivity

Blood urea nitrogen (BUN) Creatinine

Which term refers to chest pain brought on by physical or emotional stress and relieved by rest or medication? Atherosclerosis Ischemia Atheroma Angina pectoris

Angina pectoris

A nurse is monitoring a client with peptic ulcer disease. Which assessment findings would most likely indicate perforation of the ulcer? Select all that apply. A rigid, board-like abdomen Mild epigastric pain Diarrhea Tachycardia Hypotension

A rigid, board-like abdomen Tachycardia Hypotension

A client is being discharged from the emergency department (ED) after being treated for an anaphylactic reaction to shrimp the client ate for dinner. The client asks the nurse to explain food reactions. Which would be correct responses? Select all that apply. Anaphylactic reactions involve an antibody that causes the release of histamine. This reaction occurs several hours after exposure and involves antibodies that are bound to specific white blood cells Histamines produce immediate reactions. This allergy involves antibodies that circulate in the blood and cause damage to various tissues by depositing in blood vessels. Anaphylactic reactions can lead to respiratory distress and even respiratory arrest.

Anaphylactic reactions involve an antibody that causes the release of histamine. Histamines produce immediate reactions. Anaphylactic reactions can lead to respiratory distress and even respiratory arrest.

A patient has been diagnosed with pulmonary hypertension, in which the capillaries in the alveoli are squeezed excessively. The nurse should recognize a disturbance in what aspect of normal respiratory function Perfusion Acid Base Balance Diffusion Ventilation

Diffusion

The nurse is providing care for a patient with chronic obstructive pulmonary disease. When describing the process of respiration the nurse explains how oxygen and carbon dioxide are exchanged between the pulmonary capillaries and the alveoli. The nurse is describing what process? Diffusion Osmosis Filtration Active transport

Diffusion

You are caring for a patient admitted with a diagnosis of acute kidney injury. When you review your patient's most recent laboratory reports, you note that the patient's magnesium levels are high. You should prioritize assessment for which of the following health problems? Diminished deep tendon reflexes Acute Flank Pain Cool, clammy skin Tachycardia

Diminished deep tendon reflexes

The nurse is caring for a patient who is experiencing mild shortness of breath during the immediate postoperative period, with oxygen saturation readings between 89% and 91%. What method of oxygen delivery is most appropriate for the patient's needs Non-rebreathing mask Nasal cannula Partial-rebreathing mask Simple mask

Nasal cannula

A patient's injury has initiated an immune response that involves inflammation. What are the first cells to arrive at a site of inflammation? Neutrophils Eosinophils Red blood cells Lymphocytes

Neutrophils

A 27-year-old athlete with newly diagnosed asthma presents for patient education regarding situations that could precipitate an asthma attack. The nurse teaches that acute episodes of asthma may last minutes to hours. In this teaching, which precipitants would the nurse state may cause the asthma? (Select all that apply.) Pollutants Warm weather Allergens Exercise

Pollutants Allergens Exercise

You are the nurse caring for an elderly adult who is bedridden. What intervention would you include in the care plan that would most effectively prevent pressure ulcers? Post a turning schedule at the patient's bedside and ensure staff adherence. Turn and reposition the patient a minimum of every 8 hours Vigorously massage lotion into bony prominences. Slide, rather than lift, the patient when turning.

Post a turning schedule at the patient's bedside and ensure staff adherence.

A patient with primary hypertension complains of dizziness with ambulation. The patient is currently on an alpha-adrenergic blocker and the nurse assesses characteristic signs and symptoms of postural hypotension. When teaching this patient about risks associated with postural hypotension, what should the nurse emphasize? Increasing fluids to maintain BP Stopping medication if dizziness persists Rising slowly from a lying or sitting position Taking medication first thing in the morning

Rising slowly from a lying or sitting position

A patient with cardiovascular disease is being treated with amlodipine (Norvasc), a calcium channel blocking agent. The therapeutic effects of calcium channel blockers include which of the following? Increasing the efficiency of myocardial oxygen consumption, thus decreasing ischemia and relieving pain Reducing myocardial oxygen consumption by blocking adrenergic stimulation to the heart Reducing the heart's workload by decreasing heart rate and myocardial contractions Preventing platelet aggregation and subsequent thrombosis

Reducing the heart's workload by decreasing heart rate and myocardial contractions

A client who is being treated for pneumonia reports sudden shortness of breath. An arterial blood gas (ABG) is drawn. The ABG has the following values: pH 7.21, PaCO2 64 mm Hg, HCO3 24 mm Hg. What does the ABG reflect? Metabolic alkalosis Respiratory acidosis Respiratory alkalosis Metabolic acidosis

Respiratory acidosis

An elderly female patient who is bedridden is admitted to the unit because of a pressure ulcer that can no longer be treated in a community setting. During your assessment of the patient, you find that the ulcer extends into the muscle and bone. At what stage would document this ulcer? Stage IV Stage II Stage I Stage III

Stage IV

The nurse is caring for a 12-month-old child diagnosed with an autism spectrum disorder. What information from the mother during the health history should the nurse identify as being consistent with the disorder? The child sleeps at least 12 out of every 24 hours. The child responds warmly to the father but not to the mother. The child speaks in complete sentences. The child constantly stares at a rotating wheel on the crib mobile.

The child constantly stares at a rotating wheel on the crib mobile.

The nurse is collecting data on an 18-month-old child with a diagnosis of autism spectrum disorder (ASD). What clinical manifestation would likely have been noted in the child with this diagnosis? The child cries and runs to the door when the caregiver leaves the room. The child smiles when the caregiver shows her a stuffed animal. The child does not make eye contact. The child sits quietly in the caregiver's lap during the interview.

The child does not make eye contact.

The nurse is discussing macrovascular complications of diabetes with a patient. The nurse would address what topic during this dialogue? The relationship between kidney function and blood glucose levels The fact that patients with diabetes have an elevated risk of myocardial infarction The need to monitor urine for the presence of albumin The need for frequent eye examinations for patients with diabetes

The fact that patients with diabetes have an elevated risk of myocardial infarction

In children, high doses of nebulized albuterol have been associated with what conditions? (Select all that apply.) Hyperkalemia Tachycardia Hypokalemia Hyperglycemia Hypotension

Tachycardia Hypokalemia Hypotension

A nurse is planning care for a nephrology client with a new nursing graduate. The nurse states, "A client in renal failure partially loses the ability to regulate changes in pH." What is the cause of this partial inability? The kidneys buffer acids through electrolyte changes. The kidneys regulate and reabsorb carbonic acid to change and maintain pH. The kidneys reabsorb bicarbonate to maintain a stable pH. The kidneys combine carbonic acid and bicarbonate to maintain a stable pH.

The kidneys reabsorb bicarbonate to maintain a stable pH.

Aerosols are often the drugs of choice to treat asthma because of what characteristics? (Select all that apply.) They produce fewer adverse effects than oral or parenteral drugs. They can usually be given in smaller doses. They may be given less frequently. They relieve symptoms quickly. They act directly on the airways.

They produce fewer adverse effects than oral or parenteral drugs. They can usually be given in smaller doses. They relieve symptoms quickly. They act directly on the airways.

A parent asks why a physical therapist is needed for the 6-month-old child diagnosed with Down syndrome. What is the best response by the nurse? To optimize the child's development and functioning" "To ensure that the child meets all developmental milestones on time" "To prevent contractures" "The earlier the intervention, the more likely we are to cure the problem"

To optimize the child's development and functioning"

During a well-child check-up, the parents of a 9-year-old boy tell the nurse that their son's friends told him that soccer is a stupid game, and now he wants to play baseball. Which comment by the nurse best explains the effects of peer groups? "Acceptance by friends, especially of the same sex, is very important at this age." "Your child will rarely talk to you about his friends." "The children will cheer for each other regardless of the sport being played." "The child's best friends will continue playing soccer."

"Acceptance by friends, especially of the same sex, is very important at this age."

A client who has occasional gastric symptoms is receiving teaching on how to prevent gastroesophageal reflux disease (GERD). Which statement indicates the client understands the teaching? "Taking a nap after meals, when possible." "Sleeping flat without pillows is beneficial." "Eliminating bothersome foods will help." "Eating two large meals a day, instead of three."

"Eliminating bothersome foods will help."

A client with a strong family history of coronary artery disease asks the nurse how to reduce the risk of developing the disorder. Which is the best response by the nurse? "Ask your provider to prescribe the new reverse lipid drug." "Exercise, keep your blood sugar in check, and manage your stress." "Moderation is the key to everything." "Increase the soy in your diet."

"Exercise, keep your blood sugar in check, and manage your stress."

An older adult has encouraged her husband to visit their primary care provider, stating that she is concerned that he may have Parkinson's disease. Which of the wife's descriptions of her husband's health and function is most suggestive of Parkinson's disease? "He often complains that his joints are terribly stiff when he wakes up in the morning." "He's forgotten the names of some people that we've known for years." "He's losing weight even though he has a ravenous appetite." "Lately he seems to move far more slowly than he ever has in the past."

"Lately he seems to move far more slowly than he ever has in the past."

A patient with Parkinson's disease is experiencing episodes of constipation that are becoming increasingly frequent and severe. The patient states that he has been achieving relief for the past few weeks by using OTC laxatives. How should the nurse respond? "Let's explore other options, because laxatives can have side effects and create dependency." "It's important to drink plenty of fluids while you're taking laxatives." "Make sure that you supplement your laxatives with a nutritious diet." "You should ideally be using herbal remedies rather than medications to promote bowel function."

"Let's explore other options, because laxatives can have side effects and create dependency." "It's important to drink plenty of fluids while you're taking laxatives."

The clinic nurse talks with the parent of a child with Down syndrome. The parent states, "I thought my 1-year-old would be walking by now. I am concerned." What response by the nurse is best? "How old was your child when he or she first begin to smile?" "How many other children do you and your husband have?" "Milestones are often delayed for children with Down Syndrome." "We should ask a physical therapist to address your concern."

"Milestones are often delayed for children with Down Syndrome."

The nurse is assessing a 30-month-old child during a routine well-child visit. Which statement by the parent would alert the nurse to further assess for a learning disorder? "My child does not say more than one or two words and grunts to indicate needs." "My child gets restless when we go to a restaurant to eat and we have to wait for our food." "My child likes a certain type of food and does not want to try new foods very often." "My child seems to prefer playing with certain toys and will not play with other toys very much."

"My child does not say more than one or two words and grunts to indicate needs."

A mother calls the pediatrician's office upset because her 2-year-old son has begun acting out now that the new baby is home. He wants to have a bottle like the newborn and has begun to have accidents in his pants. Which statement by the nurse would best address this problem? "Offer to let him drink some formula in a cup. He will see that being a baby is not so much fun. " "You need to scold him for wetting his pants and have him change his underwear himself." "Set aside time to spend one-on-one with your older child and make him understand that he is still loved and very special." "Often, the first child is jealous of the new baby. Just ignore his acting out and he will stop."

"Set aside time to spend one-on-one with your older child and make him understand that he is still loved and very special."

A 2-year-old child has been diagnosed with autism spectrum disorder. The parents ask the nurse for a treatment that will cure the disorder. Which is the best response by the nurse? "Sometimes hiring a professional to give your child music therapy can cure this." "There are no medications available to cure autism spectrum disorder." "Your child can be put on a strict diet to guarantee that the medication works." "When your child is older, you can try nutrition supplements for a cure."

"There are no medications available to cure autism spectrum disorder."

A 3-year-old client is admitted to the pediatric unit with pneumonia. The child has a productive cough and appears to have difficulty breathing. The parents tell the nurse that the child has not been eating or drinking much and has been very inactive. Which interventions to improve airway clearance should the nurse include in the care plan? Select all that apply. -Encourage coughing and deep breathing. -Perform chest physiotherapy as ordered. -Limit fluid intake. -Keep the head of the bed flat. -Maintain humidification with a cool mist humidifier. -Perform postural drainage

-Encourage coughing and deep breathing. -Perform chest physiotherapy as ordered. -Maintain humidification with a cool mist humidifier. -Perform postural drainage

You work as a staff nurse in an emergency department. A 22-year-old woman presents to triage with a 2-day history of increasingly worse, colicky abdominal pain. She is holding her abdomen and is doubled-over as you take her vital signs. She is febrile, with a temperature of 38.9ºC (102ºF), her BP is 160/96 and HR is 112 bpm. She tells you she has not passed any stool or flatus in the past 3 days, though she feels that she needs to have a bowel movement. She tells you that she was diagnosed with Crohn's disease when she was 14 years of age. 1. Describe your priorities of care for this patient. What are your assessment priorities? Give rational. 2. What other important health history information will you gather from her? 3. What focused physical assessments will you perform? Why?

1. Describe your priorities of care for this patient. What are your assessment priorities? Identify the onset, duration, and characteristics of abdominal pain. Assess for electrolyte imbalance. Monitor for cardiac dysrhythmias related to electrolyte imbalances. Assess for GI bleeding and perforation of the bowel. 2. What other important health history information will you gather from her? Important history information includes asking about the presence of diarrhea or fecal urgency, straining at stool (tenesmus), nausea, anorexia, or weight loss; and family history of IBD. Inquire about dietary patterns, including the amounts of alcohol, caffeine, and nicotine-containing products used daily and weekly. The nurse asks about patterns of bowel elimination, including character, frequency, and presence of blood, pus, fat, or mucus. Allergies and food intolerance, especially milk (lactose) intolerance, must be noted. The patient may identify sleep disturbances if diarrhea or pain occurs at night. 3. What focused physical assessments will you perform? During the physical evaluation, heart rate, blood pressure, temperature, and body weight should be measured. Abdominal examination may reveal tenderness, distention, or masses. An anorectal examination should be performed because one third of patients have a perirectal abscess, fissure, or fistula at some time during the illness.

You are working as a nurse in a clinic that serves both an assisted living and skilled nursing facility. One of the patients is an 80-year-old woman who is a new resident of the facility. When you take her blood pressure, you note that it is 120/88 mm Hg. While talking with her, you find that she reports episodes of dizziness and has fallen twice in the past 2 weeks. She tells you that she takes her medications as prescribed and has had no other concerns. Please answer the following questions. Address each question to receive full credit. 1. What additional assessment data do you plan to gather from this patient? 2. What is your priority plan of action? Provide your rational.

1. What additional assessment data do you plan to gather from this patient? The nurse would need to gather additional assessment data from this patient. A thorough health history and physical examination are necessary. A complete history is obtained to assess for other cardiovascular risk factors and for signs and symptoms that indicate target organ damage. The nurse needs to gather information about the patient's previous diet and exercise patterns. The history should include all data pertaining to any potential medication side effects as potential deterrents to adherence, such as orthostatic hypotension. 2. What is your priority plan of action? The priority is to establish a safe environment so the patient does not fall and cause injury related to episodes of dizziness. Orthostatic hypotension is a condition commonly found in the elderly who take medication for hypertension. Elderly patients require lower doses of medication to control blood pressure. Education with the patient to avoid falls includes education on rising from a supine position to standing gradually and to ask for assistance as needed. The physician will be notified to review medications and obtain lab results to evaluate electrolytes, specifically potassium.

A 72 year-old man has been admitted to the hospital. He is confused and unable to give any information. Vital Signs : BP 122/56 sitting and BP 102/46 standing; HR 84b/min; RR 12/min. Serum sodium levels indicate that this patients has hyponatremia. Answer the following questions: What other electrolyte values will you consider? What are the causes of hyponatremia? What will you include in your assessment of this patient? Give your rationale. What specific considerations are needed for this patient because he is an older adult. Give your rational.

1. What other lab values will you consider? Urine sodium content and specific gravity. 2.What are the causes of hyponatremia? Vomiting, diarrhea, sweating, diuretic use, deficiency of aldosterone, certain medications, SIADH. 3. What will you include in your assessment of this patient? Give your rationale. Monitor fluid I&O, daily body weight, lab values, changes in LOC. Hyponatremia is a frequently overlooked cause of confusion in older adults. Lab values are monitored, specifically changes in the sodium level. Close monitoring is required for early detection and treatment in order to prevent serious consequences. 4. What special considerations are needed for this patient because he is an older adult? Give your rationale. Hyponatremia is a frequently overlooked cause of confusion in older patients, who are at increased risk because of decreased renal function and subsequent inability to excrete excess fluids.

You are a staff nurse in an outpatient dialysis facility. A 40-year-old man with ESKD (end stage kidney disease) is seen in the clinic for the first time and states that he wants to begin home hemodialysis. The patient lives alone and is employed full-time. 1. What should be the priorities for educating this patient about the options for dialysis? List all options for dialysis and explain them to the patient. 2. Is this patient a good candidate for a home hemodialysis. Why or why not? Explain. 3. How should the priorities change if the patient decides on Peritoneal Dialysis? Advantages of PD : Disadvantages of PD

1. What should be the priorities for educating this patient about the options for dialysis? Options: hemodialysis in a kidney center; home hemodialysis, and peritoneal dialysis at home. Home hemodialysis requires a highly motivated patient who is willing to take responsibility for the procedure and is able to adjust each treatment to meet the body's changing needs. It also requires the commitment and cooperation of a caregiver to assist the patient. 2. This patient lives alone and does meet the requirement for hemodialysis. 3. How should the priorities change if the patient decides on PD? Although continuous ambulatory peritoneal dialysis (CAPD) is not suitable for all patients with end-stage kidney disease (ESKD), it is a viable therapy for those who can perform self-care and fluid exchanges and fit therapy into their own routines. Often, patients report having more energy and feeling healthier once they begin CAPD. Nurses can be instrumental in helping patients with ESKD find the dialysis therapy that best suits their lifestyle. Those considering CAPD need to understand the advantages and disadvantages along with the indications and contraindications for this form of therapy. Advantages: Freedom from a hemodialysis machine, control over daily activities, opportunities to eat a more liberal diet than allowed with hemodialysis, increase fluid intake, raise serum hematocrit values, improve blood pressure control, avoid venipuncture, and gain a sense of well-being. Disadvantages: Continuous dialysis 24 hours a day, 7 days a week; dietary alterations related to protein and potassium losses. Patients may be encouraged to increase the intake of protein and potassium in the diet due to these losses with peritoneal dialysis fluid exchanges.

Which of the following women has the greatest risk of having a child with Down syndrome? 25-year-old 30-year-old 42-year-old 35-year-old

42-year-old

Naloxone 2 mg IM has been ordered for a respiratory depression on a post- surgical client. The pharmacy has sent to the floor naloxone 0.5 mg/mL. How many ml of naloxone will the client receive? 2 ml 4ml 1 ml 3 ml

4mL

A patient with ESKD is scheduled to begin hemodialysis. The nurse is working with the patient to adapt the patient's diet to maximize the therapeutic effect and minimize the risks of complications. The patient's diet should include which of the following modifications? Select all that apply. Moderate protein intake Decreased sodium intake Increased potassium intake Fluid restriction Vitamin D supplementation

???

Based on the pathophysiologic changes that occur as renal failure progresses, the nurse identifies the following indicators associated with the disease. Select all that apply. Anemia Hypocalcemia Hyperalbuminemia Hyperkalemia Metabolic alkalosis

???

The nurse is caring for a client who has just returned to the post-surgical unit following renal surgery. When assessing the client's output from surgical drains, the nurse should assess what parameters? Select all that apply. Odor of the output Visible characteristics of the output pH of the output Quantity of output Color of output

???

A client comes to the clinic and informs the nurse that he believes he is suffering from Parkinson's disease. What objective data assessed by the nurse would correlate with the client's concern? Select all that apply. Rapid speech Rigidity Tremors Tachycardia Bradykinesia

??? Q11 Rigidity Tremors Bradykinesia

The nurse is caring for a client admitted with an acute exacerbation of chronic obstructive pulmonary disease. During assessment, the nurse finds that the patient is experiencing increased dyspnea. What assessment is the best indicator of the client's oxygenation status? Pulse oximetry Capillary blood sample Arterial blood gasses (ABGs) Complete blood count (CBC)

Arterial blood gasses (ABGs)

The nurse working on a cardiac care unit is caring for a patient whose stroke volume has decreased. The nurse is aware that afterload influences a patient's stroke volume. The nurse recognizes that afterload is increased when there is what? Arterial vasodilation Venous vasoconstriction Arterial vasoconstriction Venous vasodilation

Arterial vasoconstriction

The acute medical nurse is preparing to wean a patient from the ventilator. Which assessment parameter is most important for the nurse to assess? Fluid intake for the last 24 hours Prior outcomes of weaning Baseline arterial blood gas (ABG) levels Electrocardiogram (ECG) results

Baseline arterial blood gas (ABG) levels

A patient who was diagnosed with Parkinson's disease several months ago recently began treatment with levodopa-carbidopa. The patient and his family are excited that he has experienced significant symptom relief. The nurse should be aware of what implication of the patient's medication regimen? Benefits of levodopa-carbidopa do not peak until 6 to 9 months after the initiation of treatment. Benefits of levodopa-carbidopa often diminish after 1 or 2 years of treatment. The patient's temporary improvement in status is likely unrelated to levodopa-carbidopa. The patient is in a "honeymoon period" when adverse effects of levodopa-carbidopa are not yet evident.

Benefits of levodopa-carbidopa often diminish after 1 or 2 years of treatment.

A nurse is working with a child who is undergoing a diagnostic workup for suspected asthma. What are the signs and symptoms that are consistent with a diagnosis of asthma? Select all that apply. Crackles Bradypnea Cough Wheezing Chest tightness

Cough Wheezing Chest tightness

Which disorder would alter the ability to move gases in and out of the lungs? (Select all that apply.) Sinusitis Common cold Cystic fibrosis Bronchitis Respiratory distress syndrome Atelectasis

Cystic fibrosis Bronchitis Respiratory distress syndrome Atelectasis

A diabetes nurse educator is teaching a group of patients with type 1 diabetes about "sick day rules." What guideline applies to periods of illness in a diabetic patient? Reduce food intake and insulin doses in times of illness. Do not eliminate insulin when nauseated and vomiting. Eat three substantial meals a day, if possible. Report elevated glucose levels greater than 150 mg/dL.

Do not eliminate insulin when nauseated and vomiting.

A nurse is providing care for a patient whose recent colostomy has contributed to a nursing diagnosis of Disturbed Body Image Related to Colostomy. What intervention best addresses this diagnosis? Emphasize the fact that the colostomy was needed to alleviate a much more serious health problem. Engage the patient in the care of the ostomy to the extent that the patient is willing. Emphasize the fact that the colostomy is temporary measure and is not permanent. Encourage the patient to conduct online research into colostomies.

Engage the patient in the care of the ostomy to the extent that the patient is willing.

A patient with a peptic ulcer disease has had metronidazole (Flagyl) added to his current medication regimen. What health education related to this medication should the nurse provide? Select all that apply. Finish full course of prescribed medication Take at bedtime to mitigate the effects of drowsiness. Take the medication on an empty stomach. Take up to one extra dose per day if stomach pain persists. Avoid drinking alcohol while taking the drug.

Finish full course of prescribed medication Avoid drinking alcohol while taking the drug.

An older adult patient with type 2 diabetes is brought to the emergency department by his daughter. The patient is found to have a blood glucose level of 623 mg/dL. The patient's daughter reports that the patient recently had a gastrointestinal virus and has been confused for the last 3 hours. The diagnosis of hyperglycemic hyperosmolar syndrome (HHS) is made. What nursing action would be a priority? Administering sodium bicarbonate intravenously Administration of antihypertensive medications Reversing acidosis by administering insulin Fluid and Electrolytes Replacement

Fluid and Electrolytes Replacement

You are caring for a patient who has a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH- water retention). Your patient's plan of care includes assessment of specific gravity every 4 hours. The results of this test will allow the nurse to assess what aspect of the patient's health? Calcium balance Fluid volume status Potassium balance Nutritional status

Fluid volume status

One day after a patient is admitted to the medical unit, you note that the patient is oliguric. You notify the acute-care nurse practitioner who orders a fluid challenge of 200 mL of normal saline solution over 15 minutes. This intervention will achieve which of the following? Help distinguish hyponatremia from hypernatremia Help evaluate pituitary gland function Help distinguish reduced renal blood flow from decreased renal function Help provide an effective treatment for hypertension-induced oliguria

Help distinguish reduced renal blood flow from decreased renal function

A football player is thought to have sustained an injury to his kidneys from being tackled from behind. The ER nurse caring for the patient reviews the initial orders written by the physician and notes that an order to collect all voided urine and send it to the laboratory for analysis. The nurse understands that this nursing intervention is important for what reason? -Hematuria is the most common manifestation of renal trauma and blood losses may be microscopic, so laboratory analysis is essential. -Intake and output calculations are essential and the laboratory will calculate the precise urine output produced by this patient. -There is great concern about electrolyte imbalances and the laboratory will monitor the urine for changes in potassium and sodium concentrations. -To check serum creatinine

Hematuria is the most common manifestation of renal trauma and blood losses may be microscopic, so laboratory analysis is essential.

The staff educator is teaching ED nurses about hypertensive crisis. The nurse educator should explain that hypertensive urgency differs from hypertensive emergency in what way? Hypertensive emergencies are associated with evidence of target organ damage. Hypertensive urgency is treated with rest and benzodiazepines to lower BP. The BP is always higher in a hypertensive emergency. Vigilant hemodynamic monitoring is required during treatment of hypertensive emergencies.

Hypertensive emergencies are associated with evidence of target organ damage.

You are the surgical nurse caring for a 65-year-old female patient who is postoperative day 1 following a thyroidectomy (removal of thyroid gland) . During your shift assessment, the patient complains of tingling in her lips and fingers. She tells you that she has an intermittent spasm in her wrist and hand and she exhibits increased muscle tone. What electrolyte imbalance should you first suspect? Hypermagnesemia Hyperkalemia Hypocalcemia Hypophosphatemia

Hypocalcemia

You are working on a burns unit and one of your acutely ill patients is exhibiting signs and symptoms of third spacing. Based on this change in status, you should expect the patient to exhibit signs and symptoms of what imbalance? Hypercalcemia Metabolic alkalosis Hypermagnesemia Hypovolemia

Hypovolemia

The nurse is caring for a patient with an immunodeficiency who has experienced sudden malaise. The nurse's colleague states, "I'm pretty sure that it's not an infection, because the most recent blood work looks fine." What principle should guide the nurse's response to the colleague Laboratory blood work is often inaccurate in immunodeficient patients Immunodeficient patients do not develop symptoms of infection. Infections in immunodeficient patients have a slower onset but a more severe course. Immunodeficient patients will usually exhibit subtle and atypical signs of infection.

Immunodeficient patients will usually exhibit subtle and atypical signs of infection.

The nurse is caring for an adult patient who had symptoms of unstable angina upon admission to the hospital. What nursing diagnosis underlies the discomfort associated with angina? Ineffective cardiopulmonary tissue perfusion related to coronary artery disease (CAD) Anxiety related to fear of death Ineffective breathing pattern related to decreased cardiac output Impaired skin integrity related to CAD

Ineffective cardiopulmonary tissue perfusion related to coronary artery disease (CAD)

The clinic nurse is doing a preoperative assessment of a patient who will be undergoing outpatient cataract surgery with lens implantation in 1 week. While taking the patient's medical history, the nurse notes that this patient had a kidney transplant 8 years ago and that the patient is taking immunosuppressive drugs. For what is this patient at increased risk when having surgery? Infection Adrenal storm Rejection of the implanted lens Rejection of the kidney

Infection

A male client's physician orders levodopa for the treatment of the client's Parkinson's disease. The client asks the nurse whether the levodopa will cure his condition. Which is a correct statement about the effects of levodopa? It is the treatment of last resort and may control his symptoms. It will cure the Parkinson's disease. It does not alter the underlying disease process, but it may improve a client's quality of life. It will control the symptoms for 10 to 12 years.

It does not alter the underlying disease process, but it may improve a client's quality of life.

A nurse is providing preoperative teaching to a patient who will soon undergo a cardiac bypass. The nurse's teaching plan includes exercises of the extremities. What is the purpose of teaching a patient leg exercises prior to surgery? Leg exercises increase the patient's muscle mass postoperatively. Leg exercise help increase the patient's level of consciousness after surgery. Leg exercises help to prevent pressure sores to the sacrum and heels. Leg exercises improve circulation and prevent venous thrombosis.

Leg exercises improve circulation and prevent venous thrombosis.

The nurse is working with a patient who is newly diagnosed with MS. What basic information should the nurse provide to the patient? MS usually occurs more frequently in men. MS is a progressive demyelinating disease of the nervous system. MS is sometimes caused by a bacterial infection. MS typically has an acute onset.

MS is a progressive demyelinating disease of the nervous system.

The nurse is preparing to admit a 6 year old child diagnosed with autism spectrum disorder. Prior to meeting the patient, the nurse plans to incorporate which elements into the care of this child? Select all that apply. Maintaining a quiet environment Inviting many different volunteers to visit the patient and provide variety of activities Placing the patient in a private room Asking the parents about the patient's preferences Avoiding interaction with the patient and speaking only to the parents Adhering to the patient's familiar routines

Maintaining a quiet environment Placing the patient in a private room Asking the parents about the patient's preferences Adhering to the patient's familiar routines

The nurse is performing discharge teaching for a client with rheumatoid arthritis. What teachings are priorities for the client? Select all that apply. Medication dosages and side effects Dressing changes Safe exercise Narcotic safety Assistive devices

Medication dosages and side effects Safe exercise Assistive devices

The emergency-room nurse is caring for a trauma client with the following arterial blood gas results: pH 7.26, PaCO2 28, HCO3 11 mEq/L. How should the nurse interpret these results? Respiratory acidosis with no compensation Metabolic acidosis with a compensatory respiratory alkalosis Metabolic acidosis with no compensation Metabolic alkalosis with a compensatory alkalosis

Metabolic acidosis with a compensatory respiratory alkalosis

A client with asthma should always carry a rescue inhaler or quick-relief medication with them at all times. Which of the following are considered quick-relief medications? Select all that apply: Tiotropium (Spiriva) Metaproterenol (Alupent) Albuterol (Proventin) Salmeterol (Serevent)

Metaproterenol (Alupent) Albuterol (Proventin)

The nurse is providing discharge education to a patient diagnosed with Heart Failure. What should the nurse teach this patient to do first to assess her fluid balance in the home setting? Assess her radial pulses daily Monitor her weight daily Monitor her blood pressure daily Monitor her bowel movements

Monitor her weight daily

A patient newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe? Altered glucose metabolism Pruritis (itching) Nausea and vomiting Confusion

Nausea and vomiting

A 45-year-old obese man arrives in a clinic with complaints of daytime sleepiness, difficulty going to sleep at night, and snoring. The nurse should recognize the manifestations of what health problem? Adenoiditis Laryngeal cancer Obstructive sleep apnea Chronic tonsillitis

Obstructive sleep apnea

A nurse in the neurologic ICU has orders to infuse a hypertonic solution into a patient with increased intracranial pressure. This solution will increase the number of dissolved particles in the patient's blood, creating pressure for fluids in the tissues to shift into the capillaries and increase the blood volume. This process is best described as which of the following? Hydrostatic pressure Diffusion Active transport Osmosis and osmolality

Osmosis and osmolality

The nurse is conducting a service project for a local elderly community group on the topic of hypertension. The nurse will relay that which risk factors and cardiovascular problems are related to hypertension? Select all that apply. Elevated high-density lipoprotein (HDL) cholesterol Overweight/obesity Age greater than 65 in women Decreased low-density lipoprotein (LDL) levels Smoking

Overweight/obesity Age greater than 65 in women Smoking

The nurse is caring for a cognitively impaired child and is aware that children with impaired cognition are less capable of managing environmental challenges. What related risk does the nurse anticipate for this child? Visual Impairment Nutritional deficits Psychiatric problems Physical injuries

Physical injuries

A teenage girl and her mother are in the office. When the teen uses the restroom, her mother asks the nurse about the changes that Linda is going through. She would like to talk to her about sexuality and its changes but she is unsure of how to do this. What reminders should the nurse give to the mother for when she discusses sex? Do not initiate any conversation; let the teen come and seek the advice of the parent. Encourage her to talk to her peers and teachers in health class. Promote open lines of communication; listen instead of lecture; and share family values. Discuss with the teen the experiences that you had so that she can connect on a personal level.

Promote open lines of communication; listen instead of lecture; and share family values.

A nurse is caring for a client with COPD. The client's medication regimen has been recently changed and the nurse is assessing for therapeutic effect of a new bronchodilator. Therapeutic effects of this medication would include which of the following? Select all that apply. Increased respiratory rate Increased viscosity of lung secretions Relief of dyspnea Negative sputum culture Increased expiratory flow rate

Relief of dyspnea Increased expiratory flow rate

A patient newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a patient with prolonged, uncontrolled hypertension is at risk for developing what health problem? Liver Cancer Anemia Renal failure Glaucoma

Renal failure

A client with a longstanding diagnosis of generalized anxiety disorder presents to the emergency room. The triage nurse notes upon assessment that the client is hyperventilating. The triage nurse is aware that hyperventilation is the most common cause of which acid-base imbalance? Respiratory acidosis CNS disturbances Increased PaCO2 Respiratory alkalosis

Respiratory alkalosis

The nurse is caring for a patient with multiple sclerosis (MS). The patient tells the nurse the hardest thing to deal with is the fatigue. When teaching the patient how to reduce fatigue, what action should the nurse suggest? Avoiding naps during the day Resting in an air-conditioned room whenever possible. Taking a hot bath at least once daily Increasing the dose of muscle relaxants

Resting in an air-conditioned room whenever possible.

The nurse's review of a patient's most recent blood work reveals a significant increase in the number of band cells (immature neutrophils) . The nurse's subsequent assessment should focus on which of the following? Signs and symptoms of kidney problems Evidence of decreased tissue perfusion Recent changes in activity tolerance Signs and symptoms of infection

Signs and symptoms of infection

A nurse is planning discharge teaching for a 21-year-old patient with a new diagnosis of ulcerative colitis. When planning family assessment, the nurse should recognize that which of the following factors will likely have the greatest impact on the patient's coping after discharge? The family's ability to provide emotional support The family's ability to monitor the patient's changing health status The family's ability to manage the patient's medication regimen The family's ability to take care of the patient's special diet needs

The family's ability to provide emotional support

In anticipation of a patient's scheduled surgery, the nurse is teaching her to perform deep breathing and coughing to use post-operatively. What action should the nurse teach the patient? The patient should rapidly inhale, hold for 30 seconds or as long as possible, and exhale slowly. The patient should take a deep breath in through the nose and hold it. then exhale through the mouth slowly , and cough from deep in the lungs. The patient should take three deep breaths from the mouth and exhale forcefully and then take a quick short breath and cough from deep in the lungs. The patient should take three deep breaths and cough hard three times, at least every 2 minutes for the immediately postoperative period.

The patient should take a deep breath in through the nose and hold it. then exhale through the mouth slowly , and cough from deep in the lungs.

The nurse is providing care for a patient who has just been admitted to the postsurgical unit following a laryngectomy (removal of larynx). What assessment should the nurse prioritize? The patient's swallowing ability The patient's carotid pulses Signs and symptoms of infection The patient's airway patency

The patient's airway patency

A patient with type 1 diabetes has told the nurse that his most recent urine test for ketones was positive. What is the nurse's most plausible conclusion based on this assessment finding? The patient should promptly eat some protein and carbohydrates. The patient should withhold his next scheduled dose of insulin. The patient's insulin levels are inadequate. The patient would benefit from a dose of metformin (Glucophage).

The patient's insulin levels are inadequate.

The nurse is caring for a patient admitted with unstable angina. The laboratory result for the initial troponin I is elevated in this patient. The nurse should recognize what implication of this assessment finding? This is only an accurate indicator of myocardial damage when it reaches its peak in 24 hours This is an accurate indicator of myocardial injury. Because the patient has a history of unstable angina, this is a poor indicator of myocardial injury. This result indicates muscle injury, but does not specify the source.

This is an accurate indicator of myocardial injury.

A patient with angina has been prescribed nitroglycerin. Before administering the drug, the nurse should inform the patient about what potential adverse effects? Drowsiness or blurred vision Nervousness or paresthesia Throbbing headache or dizziness Tinnitus or diplopia (double vision)

Throbbing headache or dizziness

The nurse is providing preoperative teaching to a patient scheduled for surgery. The nurse is instructing the patient on the use of deep breathing, coughing, and the use of incentive spirometry when the patient states, "I don't know why you're focusing on my breathing. My surgery is on my hip, not my chest." What rationale for these instructions should the nurse provide? To promote optimal lung expansion To prevent chronic obstructive pulmonary disease (COPD) To prevent asthma attack To prevent pneumothorax

To prevent pneumothorax

An older adult is newly diagnosed with primary hypertension and has just been started on a beta-blocker. The nurse's health education should include which of the following? Limiting exercise to avoid injury that can be caused by increased intracranial pressure Use of strategies to prevent falls stemming from postural hypotension Maintaining a diet high in dairy to increase protein necessary to prevent organ damage Increasing fluids to avoid extracellular volume depletion from the diuretic effect of the beta-blocker

Use of strategies to prevent falls stemming from postural hypotension

A nurse is preparing to provide care for a patient whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the patient's stools will have what characteristics? Hard and black or tarry Watery with blood and mucus Loose with visible fatty streaks Dry and streaked with blood

Watery with blood and mucus

A 37-year-old African American woman with a history of asthma presents to the clinic with tachypnea and acute shortness of breath with audible wheezing. She says she has continued to take her prescribed inhaler with no relief in symptoms and symptoms have gotten worst over time. She admits she was taking her inhaler more frequently than she was supposed to do. She called her doctor a week ago but could into get an appointment until today. Physical exam reveals: Tachycardia at 110 b/min; tachypnea at 30 b/min with signs of accessory muscle use; decreased breath sounds with inspiration and exploratory wheezes; SaO2 is 90% on Room Air (RA). When you ask her what type of inhaler she uses, she says she has one for fast relief but did not bring it. She also could not afford "the other one" that was prescribed 3 months ago. She never got it filled. The clinic is not equipped to give nebulizer treatments. Please answer the following questions: What is the next step of care? What type of education and resources would benefit this patient? What type of follow up is needed for this patient?

What do you think the next step of care that may be needed with this patient? Obtain peak flow monitoring. Peak flow monitoring helps measure asthma severity. Be prepared for emergency care for this patient which may include activating 911 since this clinic is unable provide immediate relief of the asthma symptoms. 2. What type of education and resources would benefit this patient? Nurses play a key role in educating patients and families as well as facilitating specific services, such as respiratory therapy education, physical therapy for exercise and breathing retraining, occupational therapy for conserving energy during activities of daily living, and nutritional counseling. First, the nurse would need to complete a learning needs assessment to determine the patient's understanding of asthma and her treatment plan. The nurse would assess the patient's knowledge base regarding: Nature of asthma as a chronic inflammatory disease Definitions of inflammation and bronchoconstriction Purpose and action of each medication Triggers to avoid, and how to do so How to perform peak flow monitoring How to implement an asthma action plan Implications regarding diet, exercise, and lifestyle changes Importance of health promotion, such as vaccines and smoking cessation (if applicable) When to seek assistance and how to do so The nurse would work with the patient to develop an education plan based on identified learning needs, such as the inability to remember the inhalers. Besides knowing the indications and actions of each medication, the patient should have education regarding adverse side effects of medication and importance of adhering to the prescribed therapy. The patient needs to know the techniques for correct medication inhalation and administration, as well as the care and cleaning of any appliances used in the delivery of the medications. Demonstration-return demonstration methods would be important for use of respiratory equipment like nebulizers, inhalers, and peak flow meters. The patient might benefit from community asthma education programs and follow-up care. Community support groups could help reinforce education. A written asthma action plan is strongly recommended to facilitate self-management. An assortment of excellent educational materials is available from the National Heart, Lung, and Blood Institute and other sources (Global Initiative for Asthma Guidelines, 2017). The nurse should obtain current educational materials for the patient based on the patient's diagnosis, causative factors, educational level, and cultural background. If a patient has a coexisting sensory impairment (e.g., vision loss or hearing impairment), materials should be provided in an alternative format. 3. What type of follow-up is needed for this patient? Follow-up for this patient will include frequent contact with the nurse to emphasize adherence to the prescribed therapy, preventive measures, and the need to keep follow-up appointments with health care providers.

A client's most recent laboratory results show a slight decrease in potassium. The health care provider has opted to forgo drug therapy but has suggested increasing the client's dietary intake of potassium. What should the nurse recommend? fish rice apples bananas

bananas

Which physical assessment finding would the physician be more likely to find in an examination of a client with Down syndrome than of other clients without Down syndrome? diabetes mellitus infertility hepatomegaly congenital heart defects

congenital heart defects

A 53-year-old man is receiving cyclosporine in order to prevent rejection of a transplanted kidney. The nurse should prioritize assessments related to: infection respiratory depression dizziness nausea

infection

A patient is receiving bumetanide (Bumex) (loop diuretic). The nurse would instruct the patient to be alert for what issues? (Select all that apply.) muscle cramps dizziness hypotension irreversible hearing loss weakness

muscle cramps dizziness hypotension weakness

A nurse working as a member of a genetic counseling team carefully assesses which body areas in a newborn to gain important indications for structural genetic disorders? eye color, skin color, and parent's race presence or absence of primitive reflexes space between the eyes, the shape of the ears, and the numbers of fingers and toes length, weight, and head circumference

space between the eyes, the shape of the ears, and the numbers of fingers and toes