N371 Exam 2 quizzes

The nurse is reviewing laboratory results for a client who has pneumonia. Which laboratory value does the nurse expect to see for this patient? A. Decreased hemoglobin B. Increased white blood cells (WBCs) C. Increased red blood cells (RBCs) D. Decreased neutrophils

B. Increased white blood cells (WBCs)

A nurse assesses a client who is prescribed fluticasone and notes oral lesions. Which action should the nurse take? A. Encourage oral rinsing after fluticasone administration. B. Document the finding as a known side effect. C. Start the client on a broad-spectrum antibiotic. D. Obtain an oral specimen for culture and sensitivity.

A - Encourage oral rinsing after fluticasone administration

A nurse plans care for an alert client who has chronic obstructive pulmonary disease and thick, tenacious secretions. Which interventions should the nurse include in this client's plan of care? (Select all that apply.) A. Use a vibrating positive expiratory pressure device. B. Encourage diaphragmatic breathing C. Ask the client to drink 2 liters of fluids daily. D. Suction the client every 2 to 3 hours. E. Keep the client in an upright position with the head of bed elevated.

A, B, C, E

A 70-year-old client has a complicated medical history, including chronic obstructive pulmonary disease. Which client statement indicates the need for further teaching about the disease? A. "I am here to receive the yearly pneumonia shot again." B. "I am here to get my yearly flu shot again." C. "I should avoid large gatherings during cold and flu season." D. "I should cough into my upper sleeve instead of my hand."

A. "I am here to receive the yearly pneumonia shot again."

A nurse admits a client who is experiencing an exacerbation of left-sided heart failure. Which action should the nurse take first? A. Assess the client's respiratory status. B. Draw blood to assess the client's serum electrolytes. C. Administer intravenous furosemide. D. Ask the client about current medications.

A. Assess the client's respiratory status.

A nurse administers medications to a client who has asthma. Which medication classification is paired correctly with its physiologic response to the medication? A. Cholinergic antagonist - Causes bronchodilation by inhibiting the parasympathetic nervous system B. Cromone - Disrupts the production of pathways of inflammatory mediators C. Corticosteroid - Relaxes bronchiolar smooth muscles by binding to and activating pulmonary beta2 receptors D. Bronchodilator - Stabilizes the membranes of mast cells and prevents the release of inflammatory mediators

A. Cholinergic antagonist - Causes bronchodilation by inhibiting the parasympathetic nervous system

A pulmonary nurse cares for clients with chronic obstructive pulmonary disease (COPD). Which client should the nurse assess first? A. A 46-year-old with a 30-pack-year history of smoking B. A 52-year-old in a tripod position using accessory muscles to breathe C. A 68-year-old who has dependent edema and clubbed fingers D. A 74-year-old with a chronic cough and thick, tenacious secretions

B. A 52-year-old in a tripod position using accessory muscles to breathe

The nurse is reviewing the laboratory results for a client whose chief complaint is dyspnea. Which diagnostic test best differentiates between heart failure and lung dysfunction? A. Hemoglobin and hematocrit B. B-type natriuretic peptide C. Arterial blood gas D. Serum electrolytes

B. B-type natriuretic peptide

An older adult resident in a long-term-care facility with a history of COPD becomes confused and agitated, telling the nurse, "Get out of here! You're going to kill me!" Which action will the nurse take first? A. Notify the resident's primary care provider. B. Check the resident's oxygen saturation. C. Give the prescribed PRN lorazepam (Ativan). D. Do a complete neurologic assessment.

B. Check the resident's oxygen saturation.

After administering newly prescribed captopril to a client with heart failure, the nurse implements interventions to decrease complications. Which priority intervention should the nurse implement for this client? A. Provide food to decrease nausea and aid in absorption. B. Instruct the client to ask for assistance when rising from bed. C. Collaborate with unlicensed assistive personnel to bathe the client. D. Monitor potassium levels and check for symptoms of hypokalemia.

B. Instruct the client to ask for assistance when rising from bed.

The nurse is caring for an 82-year-old client admitted for exacerbation of heart failure (HF). The nurse questions the client about the use of which medication because it raises an index of suspicion as to the worsening of the client's HF? A. NPH insulin B. Hydrochlorothiazide C. Ibuprofen D. Levothyroxine

C - Ibuprofen

A client with hypertension is started on verapamil. What teaching does the nurse provide for this client? A. "Monitor for muscle cramping." B. "Monitor for irregular pulse." C. "Avoid grapefruit juice." D. "Consume foods high in potassium."

C. "Avoid grapefruit juice."

A client admitted for pneumonia has been tachypneic for several days. When the nurse starts an IV to give fluids, the client questions this action, saying "I have been drinking tons of water. How am I dehydrated?" What response by the nurse is best? A. "This is really just to administer your antibiotics." B. "Why do you think you are so dehydrated?" C. "Breathing so quickly can be dehydrating." D. "Everyone with pneumonia is dehydrated."

C. "Breathing so quickly can be dehydrating."

A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure? A. "I have experienced blurred vision on several occasions." B. "I have been drinking more water than usual." C. "I must stop halfway up the stairs to catch my breath." D. "I have swelling in my legs and feet."

C. "I must stop halfway up the stairs to catch my breath."

An older adult is brought to the emergency department by a family member, who reports a moderate change in mental status and mild cough. The client is afebrile. The health care provider orders a chest x-ray. The family member questions why this is needed since the manifestations seem so vague. What response by the nurse is best? A. "The x-ray can be done and read before laboratory work is reported." B. "Chest x-rays are always ordered when we suspect pneumonia." C. "Older people often have vague symptoms, so an x-ray is essential." D. "We are testing for any possible source of infection in the client."

C. "Older people often have vague symptoms, so an x-ray is essential."

A nurse cares for a client with right-sided heart failure. The client asks, "Why do I need to weigh myself every day?" How should the nurse respond? A. "Daily weights will help us make sure that you're eating properly." B. "The hospital requires that all inpatients be weighed daily." C. "Weight is the best indication that you are gaining or losing fluid." D. "You need to lose weight to decrease the incidence of heart failure."

C. "Weight is the best indication that you are gaining or losing fluid."

The nurse is reviewing the electrocardiogram (ECG) for a client with a medical diagnosis of essential hypertension. What is the first ECG sign of heart disease resulting from hypertension? A. Malfunction of the atrioventricular (AV) node B. Malfunction of the sinoatrial (SA) note C. Left atrial and ventricular hypertrophy D. Right atrial and ventricular atrophy

C. Left atrial and ventricular hypertrophy

A client is admitted to the hospital with pneumonia. What does the nurse expect the chest x-ray results to reveal? A. Tension pneumothorax B. Thick secretions causing airway obstruction C. Patchy areas of increased density D. Large hyperinflated airways

C. Patchy areas of increased density

The night shift nurse is listening to report and hears that a client has paroxysmal nocturnal dyspnea. What does the nurse plan to do next? A. Instruct the client to sleep in a side-lying position and then check on the client every 2 hours to help with switching sides. B. Make the client comfortable in a bedside recliner with several pillows to keep the client more upright throughout the night. C. Check the client frequently because the client has insomnia due to a fear of suffocation. D. Check on the client several hours after bedtime and assist the client to sit upright and dangle the feet when dyspnea occurs.

D. Check on the client several hours after bedtime and assist the client to sit upright and dangle the feet when dyspnea occurs.

The nurse prepares to administer digoxin to a client with heart failure and notes the following information: Temperature: 99.8° F; Pulse: 48 beats/min and irregular ;Respirations: 20 breaths/min; Potassium level: 3.2 mEq/L. What action does the nurse take? A. Give the digoxin; reassess the heart rate in 30 minutes. B. Give the digoxin; document assessment findings in the medical record. C. Hold the digoxin, and obtain a prescription for an additional dose of furosemide. D. Hold the digoxin, and obtain a prescription for a potassium supplement.

D. Hold the digoxin, and obtain a prescription for a potassium supplement.

During assessment of a client with heart failure, the nurse notes that the client's pulses alternate in strength. What does this assessment indicate to the nurse? A. Pulsus paradoxus B. Hypotension C. Orthostatic hypotension D. Pulsus alternans

D. Pulsus alternans

Which intervention best assists the client with acute pulmonary edema in reducing anxiety and dyspnea? A. Reassure the client that his distress can be relieved with proper intervention. B. Place the client in high-Fowler's position with the legs down. C. Monitor pulse oximetry and cardiac rate and rhythm. D. Ask a family member to remain with the client.

Place the client in high-Fowler's position with the legs down.