16

A client in the emergency department is being discharged with a prescription for trimethoprim-sulfamethoxazole. Which statement by the client would indicate a need for further evaluation? 1. "I developed a whole-body rash while on glyburide." [47%] 2. "I drink at least 5 large bottles of water daily." [3%] 3. "I had to stop using lisinopril due to a bad cough." [19%] 4. "I have a birth control implant in place." [29%]

1

The nurse has assessed 4 children. Which finding requires immediate follow-up with the health care provider? 1. Child who had a surgical repair of hypospadias earlier today with no urinary output in the past hour [28%] 2. Child who is awaiting a neurological consult for suspected absence seizures and is sleeping soundly [13%] 3. Child who returned from a bronchoscopy an hour ago and coughed up blood-tinged sputum [29%] 4. Child with gastroenteritis, serum sodium of 131 mEq/L (131 mmol/L), and temperature of 100 F (37.7 C) [28%]

1

Exhibit The charge nurse observes a new staff nurse collecting a urine sample for urinalysis and culture as pictured. What is the charge nurse's best action? Click on the exhibit button for additional information. 1. Advise the staff nurse to discard the collected urine specimen and record the output [45%] 2. Advise the staff nurse to put the lid on the cup and immediately transfer it to a biohazard bag [23%] 3. Instruct the staff nurse to discard the first small amount of urine before collecting the sample [22%] 4. Remind the staff nurse that the specimen should be kept cool until it is sent to the laboratory [8%]

1

Immediately after delivery, an 8 lb 9 oz client requires naloxone hydrochloride due to respiratory depression. The health care provider prescribes naloxone 0.01 mg/kg to be given intramuscularly stat. Naloxone 0.04 mg/mL is available. How many milliliters will the nurse administer? Record your answer using two decimal places. Answer: (mL) 0.97

0.97

Exhibit A client with cancer is to receive a third dose of cisplatin. The client's laboratory results are shown in the exhibit. Which factor would be important for the nurse to assess before confirming the dose with the health care provider? Click on the exhibit button for additional information. 1. Blood pressure [7%] 2. Capillary refill [1%] 3. Skin turgor [1%] 4. Urine output [88%]

4

The nurse plans care for a 3-year-old who was admitted with suspected pertussis infection. Which instructions will the nurse include in the plan of care? Select all that apply. 1. Institute droplet precautions 2. Monitor for signs of airway obstruction 3. Offer small amounts of fluids frequently 4. Place the child in a negative-pressure isolation room 5. Request an order for cough suppressant

123

The nurse is caring for a client diagnosed with endometrial cancer who is receiving brachytherapy. Which interventions should the nurse implement while caring for this client? Select all that apply. 1. Cluster care to limit each staff member's time in the room to 30 minutes a shift 2. Instruct the client to be up and around in the room but not to leave the room 3. Keep the door to the room closed as radiation is emitting constantly from the client 4. Teach family members and visitors to stay at least 6 feet away from the client 5. Use a lead apron when providing direct client care to reduce exposure to radiation 6. Wear a radiation film-badge while in the client's room to monitor radiation exposure

13456

The health care provider has just prescribed tetracycline for an adolescent with acne vulgaris. The client takes oral contraceptive pills. The clinic nurse should educate the teen about which topics? Select all that apply. 1. Not taking tetracycline with dairy products 2. Taking tetracycline at bedtime 3. Taking tetracycline with food 4. Using additional contraceptive techniques 5. Using sunblock

145

A child with cystic fibrosis is to receive a dose of pancrelipase at 12:00 PM. The client states that he is not hungry and will eat his lunch in an hour. Which action is appropriate for the nurse to take? 1. Administer the prescribed pancrelipase [13%] 2. Hold the pancrelipase until the client eats [83%] 3. Notify the health care provider [3%] 4. Skip this dose of the pancrelipase [0%]

2

A client is 6 hours postoperative from hip surgery after receiving regional anesthesia and has epidural continuous anesthesia in place. Which is the most important reason for the nurse to contact the health care provider? 1. Client reports paresthesia bilaterally since the surgery [36%] 2. Fondaparinux is prescribed for STAT administration [25%] 3. Lower-extremity muscle strength is 3/5 bilaterally [9%] 4. Postoperative laboratory results show hemoglobin of 9.9 g/dL (99 g/L) [28%]

2

A nurse has received new medication prescriptions for a client admitted with hypertension and an exacerbation of chronic obstructive pulmonary disease. Which prescription should the nurse question? 1. Amlodipine [12%] 2. Codeine [63%] 3. Ipratropium [13%] 4. Methylprednisolone [11%]

2

The charge nurse is notified that a client is being admitted with a diagnosis of active shingles with a disseminated rash. Which room assignment is most appropriate for this client? 1. A private room with contact and droplet precautions [36%] 2. A private room with negative airflow and contact and airborne precautions [44%] 3. A private room with positive airflow and airborne precautions [5%] 4. A semi-private 2-bed room with standard precautions [13%]

2

The clinic nurse supervises a graduate nurse who is teaching the parents of a 2-year-old with acute diarrhea about home management. The nurse would need to intervene when the graduate nurse provides which instruction? 1. "Do not administer antidiarrheal medications to your child." [26%] 2. "Follow the bananas, rice, applesauce, and toast diet for the next few days." [32%] 3. "Record the number of wet diapers and return to the clinic if you notice a decrease." [28%] 4. "Use a skin barrier cream such as zinc oxide in the diaper area until diarrhea subsides." [12%]

2

The registered nurse is teaching the parent of a 6-year-old about behavioral strategies for treating fecal incontinence due to functional constipation. Which statement by the parent indicates a need for further teaching? 1. "I will give my child a picture book to look at during toilet time." [29%] 2. "I will give my child a reward for each bowel movement while sitting on the toilet." [34%] 3. "I will keep a log of my child's bowel movements, laxative use, and episodes of soiling." [23%] 4. "I will schedule regular toilet sitting time for my child." [11%]

2

Which herbal supplements pose an increased risk for bleeding in surgical clients and should be discontinued prior to major surgery? Select all that apply. 1. Black cohosh 2. Garlic 3. Ginger 4. Ginkgo biloba 5. Hawthorn

234

A female client is admitted to the emergency department after a motor vehicle collision. The client is unresponsive and on a mechanical ventilator. Which actions should the nurse perform? Select all that apply. 1. Locate and remove any medication patches 2. Locate possible medical alert band or necklace 3. Remove rings and jewelry and lock in a secure location 4. Remove tampon and replace with menstrual pad 5. Take out contacts if no presence of eye trauma

2345

A client diagnosed with vaginal candidiasis is instructed on self-care management techniques and proper administration of the prescribed miconazole vaginal cream. Which statement by the client indicates that further teaching is needed? 1. "Each time I use the bathroom, I will wipe myself from the front to the back." [2%] 2. "I should choose loose-fitting cotton underwear instead of nylon undergarments." [6%] 3. "I will refrain from having sex until my partner is also tested and treated for the infection." [67%] 4. "Prior to going to bed at night, I will apply miconazole cream using the vaginal applicator." [23%]

3

The nurse has received a prescription from the health care provider to administer 80 mg methylprednisolone IVP. The available vial contains 125 mg in 2 mL. Select the syringe containing the appropriate amount of medication to be administered. 1. [8%] 2. [13%] 3. [68%] 4. [9%]

3

The nurse is caring for a client who started receiving chemotherapy 10 days ago. Today, the health care provider prescribes filgrastim. Which of the following is an expected outcome of this medication? 1. Decrease in serum uric acid [12%] 2. Increase in hemoglobin level [8%] 3. Increase in neutrophil count [63%] 4. Increase in platelet count [15%]

3

The nurse is preparing to administer the fourth dose of vancomycin IVPB to a client with infective endocarditis. Which intervention does the nurse anticipate? 1. Administering PRN antiemetic prior to the infusion [2%] 2. Administering via an infusion pump over at least 30 minutes [20%] 3. Drawing a trough level just prior to administration of the vancomycin [71%] 4. Starting a new IV line before administration [5%]

3

The nurse provides discharge teaching for the parents of a child newly diagnosed with hemophilia A. Which statements by the parents indicate that teaching has been effective? Select all that apply. 1. "A high-calorie, high-protein diet is best for our child." 2. "It is extremely important that we do not allow our child to become dehydrated." 3. "Our child should wear a medical alert bracelet at all times." 4. "We should avoid giving our child over-the-counter medicine containing aspirin." 5. "We should encourage a noncontact sport such as swimming."

345

A 1-year-old child who goes to day care is recovering from an episode of otitis media. Which intervention is most important for the nurse to recommend to the parents in order to prevent recurrence? 1. Exclusive breastfeeding [2%] 2. Not sending the child to day care [1%] 3. Preventing water from entering the ear [44%] 4. Smoking cessation by the parents [51%]

4

A nurse has completed teaching a client who is being discharged on lithium for a bipolar disorder. Which statement by the client indicates a need for further teaching? 1. "I need to drink 1-2 liters of fluid daily." [8%] 2. "I need to have my blood levels checked periodically." [3%] 3. "I should not limit my sodium intake." [49%] 4. "I should use ibuprofen for pain relief." [39%]

4

The clinic nurse is teaching a client about levothyroxine, which the health care provider has prescribed for newly diagnosed hypothyroidism. Which statement made by the client indicates that further teaching is needed? 1. "I will need to get my blood drawn to see if I'm taking the right dose." [7%] 2. "I will probably need to take this the rest of my life." [5%] 3. "I will take this once a day in the morning." [3%] 4. "If this makes my stomach upset, I will take it with an antacid." [82%]

4

The nurse is preparing to administer the fourth dose of IV vancomycin to a client. Which set of laboratory values would alert the nurse to hold the vancomycin and notify the health care provider? 1. Vancomycin trough 10 mg/L (6.9 µmol/L), creatinine 1.1 mg/dL (97.2 µmol/L), BUN 6 mg/dL (2.1 mmol/L) [6%] 2. Vancomycin trough 14 mg/L (9.7 µmol/L), creatinine 1.2 mg/dL (106.1 µmol/L), BUN 10 mg/dL (3.6 mmol/L) [1%] 3. Vancomycin trough 18 mg/L (12.4 µmol/L), creatinine 0.6 mg/dL (53 µmol/L), BUN 18 mg/dL (6.4 mmol/L) [4%] 4. Vancomycin trough 23 mg/L (15.9 µmol/L), creatinine 1.5 mg/dL (132.6 µmol/L), BUN 24 mg/dL (8.6 mmol/L) [87%]

4

The nurse should consider which of the following client reports as an indication of an allergic reaction? 1. "I can't eat broccoli or cabbage when I take my warfarin." [0%] 2. "I get a headache when using my nitroglycerine patch." [0%] 3. "My feet swell when I take felodipine." [0%] 4. "My lips swell when I eat bananas or avocados." [98%]

4

A community health nurse evaluates several clients' vaccination status. Which clients would the nurse recommend receive the influenza vaccine injection? Select all that apply. 1. 9-month-old with no known medical conditions 2. 5-year-old with congenital heart defect 3. 23-year-old recently diagnosed with HIV 4. 45-year-old caretaker of elderly parent 5. 75-year-old with end-stage renal failure

all

The nurse is performing a well-child assessment on a sleeping 2-month-old client. Organize the assessment in the correct order based on the developmental age of the client. All options must be used.

right

The nurse prepares to draw up regular and NPH insulins into one syringe. Place in order the steps the nurse should take when mixing the insulins. All options must be used. Your Response/ Incorrect Response Clean the vial tops with alcohol swabs Inject air into the regular insulin vial Draw up the regular insulin solution Inject air into the NPH insulin vial Draw up the NPH insulin solution Correct Response Clean the vial tops with alcohol swabs Inject air into the NPH insulin vial Inject air into the regular insulin vial Draw up the regular insulin solution Draw up the NPH insulin solution

right