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What are some elevated serum lab results seen early with a patient with rhabdomyolysis? A. Creatinine kinase (CK) levels B. Hyperkalemia C. Hyperphosphate levels D. Uric Acid E. Creatinine F. BUN levels G. Hypercalcemia

a b c d e f

Which side effect may occur in a patient who is taking metoprolol? A. Cough B. Diarrhea C. Hypovolemia D. Orthostatic hypotension

d

Which patient is at greatest risk for developing an infection? A. A 54-year-old man with hypertension B. A 17-year-old girl with a fractured tibia in a cast C. A 65-year-old woman who had coronary bypass surgery 4 days ago D. A 71-year-old man with dementia in a nursing home

c

1) The nurse is completing a neurovascular assessment of a fractured lower extremity after a surgical intervention to reduce the fracture. Which parameters are included as part of a neurovascular assessment? Select All That Apply. A. Color B. Temperature C. Capillary refill time D. Pulse E. Pain F. Sensation G. Movement

a b c d e f g

Which information would the nurse include regarding appliance care and maintenance, when teaching a client with a new colostomy? Select all that apply. A. Change the ostomy pouch on a routine basis. B. Replace the ostomy wafer weekly or sooner as needed. C. Remove the ostomy pouch when showering. D. Empty the ostomy pouch when three-quarters full of stool or gas. E. Empty the ostomy pouch before exercise and at bedtime.

a b e

In anticipation of a client returning to their room following a subtotal thyroidectomy, what intervention would be highest priority for the nurse to perform? A. Have sterile dressing supplies in the room. B. Place a tracheostomy set at the bedside. C. Lock the client's bed in a supine position until surgeon orders a different position.

b

A patient who had gastrointestinal surgery has an oxygen saturation of 91%, a heart rate of 98 beats/min, and dyspnea with mild exertion, but has clear breath sounds and a normal respiratory effort. The patient's nail beds are pale. Which action does the nurse take next? A. Elevate the head of the bed to 30 degrees. B. Notify the Rapid Response Team. C. Request an order for a complete blood count. Suggest that the patient increase oral fluid intake.

c

An older patient has muscle wastage and loss of subcutaneous fat in the extremities. What nutritional intervention does the nurse suggest to the patient and caregiver? A. Add vitamin A supplements to the diet. B. Choose foods rich in calcium and vitamin D. C. Include foods rich in calories and proteins. D. Take iron and folic supplements daily.

c

1) A patient has been taking high doses of oral glucocorticoids for an extended period of time to treat arthritis. What is the effect of long-term high-dose, oral glucocorticoids on the skeletal system? a. Increased bone resorption by osteoblasts. b. Decreased bone formation by osteoclasts. c. Increased intestinal absorption of calcium d. Decreased bone mineral density and resultant fractures.

d

On the first postoperative day following a thyroidectomy, a client tolerates a full-fluid diet. This is changed to a soft diet on the second postoperative day. The client reports a sore throat when swallowing. What should the nurse do first? A. Reorder the full-fluid diet. B. Notify the primary healthcare provider. C. Administer analgesics as prescribed before meals. Provide saline gargles to moisten the mucous membranes.

c

The nurse is monitoring a patient who is receiving an intravenous fat emulsion (IVFE) nutritional supplement. What action does the nurse take in the event that the patient develops fever, increased triglycerides, and clotting problems? A. Discontinues the IVFE infusion B. Documents the findings and continues to monitor C. Slows the rate of flow of the IVFE infusion D. Switches to total parenteral nutrition (TPN)

a

1) The nurse is caring for a client who has had spinal fusion, with insertion of hardware. The nurse would e most concerned with which assessment finding? A. Temperature of 101.6 F (38.7C) orally. B. Complaints of discomfort during repositioning. C. Old bloody drainage outlined on the surgical dressing. D. Discomfort during coughing and deep breathing exercises.

a

A client is being discharged after having a total thyroidectomy. Which instruction is most important for the nurse to include? A. Take thyroid replacement medications as prescribed. B. Be aware of signs and symptoms of dehydration. C. Avoid all over-the-counter medications. D. Report signs of hypoglycemia.

a

A patient is prescribed atorvastatin and reports severe muscle cramping. Which intervention would be performed first to improve the patient's condition? A. Discontinuing the therapy B. Administering acetaminophen C. Encouraging the patient to exercise D. Consuming adequate amount of fluids

a

The nurse is caring for a patient with lower extremity peripheral arterial disease. Which precaution should the nurse ask the patient to take? A. "You should avoid crossing your legs." B. "You should raise your legs above the heart level." C. "You may ignore any change that your feet may develop." D. "You should apply direct heat to your limbs using extremely hot water."

a

A client with a partial occlusion of the left common carotid artery is to be discharged while still receiving warfarin. Which clinical adverse effect should the nurse identify as a reason for the client to seek medical consultation? Select all that apply. A. Presence of blood in urine (hematuria). B. Bruising noted at various stages of healing. C. Delayed clotting from minor cuts and scrapes. D. Minor bleeding from gums only when brushing teeth. E. Vomiting coffee-ground emesis.

a e

1) During care of the patient with multiple myeloma, an important nursing intervention is: A. Limiting weight-bearing and ambulation. B. Maintaining a fluid intake of 3 to 4 L/day. C. Assessing lymph nodes for enlargement. D. Administration of calcium supplements.

b

1) When caring for a patient who has had a head injury, which assessment information is of most concern to the nurse? A. The blood pressure increases from 120/54 to 136/62. B. The patient is more difficult to arouse. C. The patient complains of a headache at pain level 5 of a 10-point scale. D. The patient's apical pulse is slightly irregular.

b

A nurse teaches a client with type 1 diabetes how to best treat hypoglycemia. If the teaching is effective, which foods does the client identify to manage hypoglycemia? A. Hard candy and fruit juice B. Cheese sandwich and sugar C. Chocolate candy and an orange D. Peanut butter crackers and a glass of milk

b

A patient with leukemia who is undergoing chemotherapy reports increasing fatigue. A family member tells the nurse that the patient has difficulty eating and asks what the patient should eat to help improve energy. What does the nurse recommend for this patient? A. Calorie-dense foods such as ice cream B. High-carbohydrate and high-protein foods C. Red meats and green, leafy vegetables D. Vitamin and mineral supplements

b

1) A patient returns from surgery with an indwelling urinary catheter in place and empty. Six hours later the volume is 120ml. The drainage system has no obstructions. Which intervention has priority? A. Administer a 500 ml bolus of normal saline solution. B. Assess the patient's circulation and vital signs C. Flush the urinary catheter with sterile water. D. Place the patient in the shock position and contact the physician.

b

1) Routine laboratory monitoring in clients taking ß blockers should include: A. Sodium B. Glucose C. Thyrotropin D. Creatine phosphokinase

b

1) Which nurse does the charge nurse assign to care for a 64-year-old patient who has pneumonia and requires IV antibiotic therapy and IV fluids at 200 mL/hr? A. An experienced LPN/LVN who has worked on the medical unit for 10 years B. RN with experience in the operating room who transferred a month ago to the medical unit C. A float RN with 7 years of experience on the inpatient oncology unit D. RN who has worked mostly on the same-day surgery unit since graduating a year ago

c

The nurse assesses the patient with which hematologic problem first? A. 32-year-old with pernicious anemia who needs a vitamin B 12 injection B. 40-year-old with iron deficiency anemia who needs a Z-track iron injection C. 67-year-old with acute myelocytic leukemia with petechiae on both legs 81-year-old with thrombocytopenia and an increase in abdominal girth

d


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