exam 3 practice questions

After administering hydralazine 5mg IV as prescribed for primigravida client with severe preeclampsia at 38 weeks gestation, the nurse should assess the client for which complication? 1. tachycardia 2. bradypnea 3. polyuria 4. dysphagia

1

the nurse is teaching a client with HTN about atenolol. what should the nurse instruct the client to do? 1. avoid sudden discontinuation of the drug 2. monitor the bp annually 3. follow a 2-g sodium diet 4. discontinue the medication if severe headaches develop

1

what is most important information for the nurse to teach a client newly diagnosed with genital herpes? 1. use condoms at all times during sexual intercourse 2. a urologist should be seen only when lesions occur 3. oral sex is permissible without a barrier 4. determine if your partner has received a vaccine against herpes

1

which child is most at risk for SIDS? 1. infant who is 3 months old 2. 2y/o who has apnea lasting up to 5 seconds 3. firstborn child whose parents are in their early 40s 4. 6 month old who has had two bouts of pneumonia

1

which complication will the nurse monitor for in a child receiving mechanical ventilation? 1. pneumothorax 2. high cardiac output 3. polycythemia 4. hypovolemia

1

which group has experienced the greatest rise in incidence of sexually transmitted diseases over the past two decades 1. teenagers 2. divorced people 3. young married couples 4. older adults

1

the nurse is caring for multiple preeclamptic clients, all receiving MGs04. which assessment findings will the nurse report to the HCP? SATA 1. reports of epigastric pain 2. 35 ml of urine output in 2 hours 3. 4+ deep tendon reflexes 4. Respiratory rate 8 breaths/min 5. platelet level of 100,000

1,2,3,4,5

A client diagnosed with primary HTN is taking chlorothiazide. The nurse determines teaching about this medication is effective when the client makes which statement, SATA 1. ill weigh myself at the same time each day 2. I wont drink alcoholic beverages while on this medication 3. ill reduce salt intake in my diet 4. if I have severe dizziness, ill reduce my dosage 5. if I have prolonged exposure to sunlight, ill use sunscreen 6. ill take the drug before I go bed

1,2,3,5

a client is seen in the ER and the HCP suspects an AAA. which action is priority for the nurse to perform? SATA 1. monitor and record VS 2. monitor intake, output and lab values 3. observe client for signs of hypovolemic shock 4. apply a non-rebreather oxygen mask 5. prepare the client for an abdominal ultrasound

1,2,3,5

the nurse will recommend which activity for a client at risk of developing HTN? SATA 1. maintain a healthy weight for height 2. attend smoking cessation classes 3. participate in physical activity once per week 4. eat a diet low in sodium and high in potassium 5. drink less than three alcoholic beverages per day

1,2,4 actives that dec risk factor= maintain healthy weight, smoking cessation, participating in physical activity at least 3x per week, eating a diet low in sodium and high in potassium (helps keep blood pressure low), and limiting alcohol consumption

the nurse suspects a 3-hour old neonate is experiencing newborn distress based on which findings? SATA 1. rr of 15 breaths/minute 2. sternal retractions 3. acrocyanosis 4. grunting 5. nasal flarring

1,2,4,5

a client who has DM is taking metoprolol For HTN. What should the nurse instruct the client to do? SATA 1. take the tablets with food at same time each day 2. do not crush or chew the tablet 3. notify the HCP if pulse is 82 beats/min 4. have a blood glucose level drawn every 6-12 hours 5. use an appropriate decongestant if needed. 6. Report any fainting spells to the HCP?

1,2,4,6

the client is prescribed amlodipine. which primary actions will the nurse discuss with the client? SATA 1. dilation of artiers 2. decrease PVR 3. increases overload 4. reduces afterload 5. promotes calcium influx

1,2,4. Amlodipine is a calcium channel blocker, which inhibits calcium influx through the coronary arteries, causing arterial dilation and decreasing PVR, which reduces afterload

A 5 y.o child is admitted with a diagnosis of croup. which characteristic signs will the nurse expect to see in this client? SATA 1. barking cough 2. temp of 100.8 3. blood pressure of 105/60 4. RR of 25 5. HR of 140 BPM

1,2,5

when explaining to parents how to reduce SIDS, the nurse should teach about which of the following. SATA 1. maintain a smoke free environment 2. use a wedge for side-lying position 3. breastfeed the baby 4. place the baby on his/her back to sleep 5. use bumper pads over the bed rails 6. have the baby sleep in the partners bed

1,3,4

which information should the nurse include when teaching a 55 year old woman in the beginning of menopause? SATA 1. the average onset for menopause is 50-52 years 2. vaginal infections will increase 3. depression is very common as a result of menopause 4. hot flashes, especially at night can occur in about 80% of women 5. when periods become irregular, contraception is unnecessary

1,4

the nurse is administering IV mgso4 as prescribed for pt 34 weeks pregnant with severe pre-eclampsia. what are the desired outcomes? SATA 1. temp= 98.7, pulse 72 bpm, rr=14 2. urinary output <30mL/hr 3. fetal heart rate with late decelerations 4. blood pressure 140/90 mm Hg 5. deep tendon reflexes +2 6. Magnesium level = 5.6 mg/dL

1,5,6

the nurse recognizes a client with severe HTN will experienced increased workload that can be attributed to which process? 1. increased afterload 2. increased CO 3. increase preload 4. overload of the heart

1- after load refers to the resistance normally maintained by the aortic and pulmonic valves, the condition and tone of the aorta, and the resistance offered by the systemic and pulmonary arteries. HTN increases after load as the left ventricle has to work harder to eject blood against vasoconstriction

metoprolol is added to a female diabetics med list with stage 2 HTN, who was initially treated with furosemide and ramipril. the nurse should evaluate the client for which expected therapeutic effect? 1. dec the heart rate 2. lessening of fatigue 3. improvement in blood sugar levels 4. increase in urine output

1-- effect of beta blocker is decrease in HR, contractility and after load, leading to dec BP.

A client who is 34 weeks pregnant is admitted to L&D with dx of pre-eclampsia. VS= BP=149/92, Pulse= 62 BPM, rr=18, temp=98.4. What is the priority intervention 1. encourage the client to lie in a lateral position 2. administer an antihypertensive agent 3. Notify the health care provider of the client blood pressure 4. check the cervis

1--- decreases pressure on arteries and decreases blood pressure

the nurse receives report on a client who has been diagnosed with an AAA. the nurse will expect the client to have which underlying disease? 1. atherosclerosis 2. type 1 DM 3. COPD 4. renal failure

1--atherosclerosis is linked to 75% of all AAA. plaque damages the wall of the artery and weakens it, causing an aneurysm

the nurse is caring for several neonates, all born vaginally. which neonate will the nurse monitor for the development of RDS? 1. the neonate born at 32 weeks gestation 2. the neonate born at 41 weeks gestaton 3. the neonate with a pH level of 7.37 4. the neonate with 54 respirations per minute

1-prematurity is the single most important risk factor for developing RDS

a child presents with inspiratory stridor and a seal-like barking cough. which nursing action is priority? 1. provide oxygen via a face mask 2. establish and maintain the airway 3. administer IV antibiotics 4. assess the oxygen saturation rate

2

a client with PAD has undergone a right femoral-popliteal bypass graft. The blood pressure has decreased from 124/80 to 88/62. what should the nurse assess first? 1. iv fluid infusion rate 2. pedal pulses 3. nasal cannula flow rate 4. capillary refil

2

what is a risk factor for women who have HPV 1. sterility 2. cervical cancer 3. uterine fibroid tumors 4. irregular menses

2

which education is most important for the nurse to provide to the parents of a child in the recovery stage of croup? 1. limit the Childs oral fluid intake 2. recognize the signs of respiratory distress 3. provide three nutritious meals per day 4. allow the child to go to the playground

2

the nurse is assessing the lower extremities of the client with PAD. which findings are expected? SATA 1. hairy legs 2. mottled skin 3. pink skin 4. coolness 5. moist skin

2, 4

what instructions should the nurse give the client who will be starting a prescription for simvastatin 40mg/day? SATA 1. take once a day in the morning 2. if you miss a dose, take it when you remember it 3. limit greens such as lettuce in the diet to prevent bleeding 4. be sure to take the pill with food 5. report muscle pain or tenderness to your health care provider 6. continue to follow a diet that is low in saturated fats

2,5,6

the nurse knows which client is at highest risk of developing an AAA? (Think aneurysm in general) 1. 54 y.o female who has infection of aorta and a fam hx of heart failure 2. 69 y.o male client who has smoked for 55 years and whose bp is 144/92 3. a 75 y.o female client with new onset of type 1 dm and a hx of alcohol use disorder 5. a 60 y.o male client whose father died suddenly from a ruptured AA

2- risk factors for an aneurysm= age 65 and older, tobacco use, caucasian ethnicity, male gender, family history, atherosclerosis, hypertension and a history of large vessels aneurysms

A client has PAD of both lower extremities. The client tells the nurse, "ive really tried to managed my condition well." Which example indicates the client is using appropriate care management strategies? 1. the client rests with the legs elevated above the level of the heart 2. the client walks slowly but steadily for 30 minutes twice a day 3. the client limits activity to walking around the house 4. the client wears anti embolism stockings at all times when OOB

2- slow & steady walking is a recommended activity

which finding warrants immediate nursing intervention in a child diagnosed with croup? 1. a barking cough 2. intercostal retractions 3. clubbing of the fingers 4. temperature of 99.6

2--occur as the Childs breathing becomes more labored and the use of other muscles is necessary to draw air into the lungs

16 y.o primigradvid client 37 weeks gestation with severe pre-eclampsia is in early active labor. BP= 164/110 mm Hg, which finding would alert the nurse that the client may. be about to experience a seizure? 1. decreased contraction intensity 2. decreased temperature 3. epigastric 4. hyporeflexia

3

A client with angina is taking nifedipine. what instruction should the nurse give the client? 1. monitor bp monthly 2. perform daily weights 3. inspect gums daily 4. limit intake of green leafy vegetables

3

a client is newly diagnosed with HTN of unknown origin. During the assessment, the clients bp is 152/92 and the client is asymptomatic, how will the nurse document this? 1. accelerated HTN 2. malignant HTN 3. primary HTN 4. secondary HTN

3

a client with HIV is taking zidovudine (AZT). what is the expected outcome? 1.destroy the virus 2.enhance the bodys antibody production 3. enable slow replication of the virus 4. neutralize toxins produced by the virus

3

the nurse is assessing a client who has a history of PAD. the nurses observes that the left great toe is black. the nurse determines that the black color is caused by which factor 1. atrophy 2. contraction 3. gangrene 4. rubor

3

the nurse teaches a client who has recently been diagnosed with HTN about following a low-calorie, low-fat, low-sodium diet. which menu selection would best meet the clients needs? 1. mixed green salad with blue cheese dressing, crackers, and cold cuts 2. ham sandwich on rye bread, and an orange 3. baked chicken, an apple, and a slice of white bread 4. hot dogs, baked beans, and celery and carrot sticks

3

the nurse is caring for a neonate whose mother received Mgso4 during labor. the nurse will closely monitor the neonate for which potential problems? SATA 1. hypoglycemia 2. twitching 3. respiratory depression 4. tachycardia 5. bradycardia

3,5-- adverse neonatal effects include Respiratory depression, hypotonia, and bradycardia

A woman with preeclampsia is receiving mgs04 via infusion pump at 1g/h. the nurses assessment includes: temp=36.7, pulse=78, respirations=12/min, BP= 128/82, urinary output= 90 mL in last 4 hours via urinary cattier, patellar-tendon reflex absent; ankle clonus absent; fetal hr=120 bpm, cervix 4 cm dilated, 80% effaced, station -1. Which is the MOST appropriate action for the nurse to take? 1. assess the urinary catheter for kinks in the drainage tubing and obtain a urine sample 2. document finidngs, and continue to monitor her progress in labor 3. discontinue the MGso4 infusion and notify the HCP 4. increase fluid intake IV and measure intake and output

3- signs of mgs04 toxicity= loss of deep tendon reflexes, urinary output should 30mL/hr, respirations are decreasing

the nurse is caring for a child with a dx of croup. which response will the nurse provide the caregiver when concern is expressed about the child waking at night coughing? 1. immediately call 911 2. transport the child to an ambulatory care center 3. take the child in the bathroom, shut the door, and turn on a hot shower 4. administer a home nebulizer treatment to the child

3- steam from the shower would decrease laryngeal spasms

an adult client with HF and 2+ pitting edema is prescribed furosemide. which supplemental medication dos the nurse expect will be prescribed for this client? 1. chloride 2. digoxin 3. potassium 4. sodium

3---furosemide is a loop diuretic, that cause HYPOkalemia

the nurse identifies which client to be at greatest risk for developing HTN? 1. a 45 y.o caucasian women who has DM and drinks a glass of wine once a month 2. A 58 y.o Caucasia man who works in a factory and does not eat gluten or dairy products 3 a 49 y.o women of African decent who is moderately overweight and birthed four children 4. a 52 year old man of African American decent who has a sedentary lifestyle and drinks beer daily

4

the client with PAD has been prescribed dilitazem. to determine the effectiveness of the medicine, the nurse should assess the client for which intended outcome? 1. decreased anxiety 2. prolonged sleep 3. cooler extremities 4. improved blood flow

4- dilitazem is a calcium channel blocker-- promotes vasodilation, and prevents spasms fo the arteries so blood, oxygen and nutrients can reach the muscles and tissues

the nurse is educating the parents of a 5 year old child diagnosed with croup. which intervention will the nurse include to help alleviate worsening symptoms during the night? 1. give warm liquids 2. raise the heat setting on the thermostat 3. place the child in a tub of cold water 4. provide humidified air with cool mist

4- high humidity with cool mist, sun as fro a cool mist humidifier, provides the most (and safest form of) relief.

the client with PAD & hx of HTN is to be discharged on a low-fat, low-cholesterol, low-sodium diet. Which should be the nurses first step in planning the dietary instructions? 1. determine the clients knowledge level about cholesterol 2. ask the client to name foods high in fat, cholesterol, and salt 3. explain the importance of complying with the diet 4. assess the family food preferences

4- nurse must assess the clients pattern of food intake, lifestyle, food preferences and ethnic/cultural/financial influences

the nurse teaches a client with HF to take oral furosemide in the morning. what is the expected outcome for taking this drug in the morning.. the client will: 1. avoid concentrated urine 2. prevent the risk of falling 3. limit the excretion of electrolytes 4. obtain more sleep

4--will not need to void frequently at night, resulting in the client sleeping more. since the client is sleeping more and not out of bed, there will not be a fall risk. if the client takes the medicine at night and has to frequently get out of bed, then there will be an increased fall risk.

when the nurse is assessing an individual with PAD, which clinical manifestation would indicate complete arterial obstruction in the lower left leg? 1. aching pain the left calf 2. burning pain in the left calf 3. numbness and tingling in the left leg 4. coldness of the left foot and ankle

4-coldness in the left food and ankle is consistent with complete arterial obstruction, other expected findings= paralysis and pallor