Final question bank

A nurse is administering insulin glulisine 10 units subcut at 0730 to an adolescent client who has type 1 diabetes mellitus. The nurse should anticipate the insulin's onset of action at which of the following times ?

0745 -this is a fast actin insulin with onset of 15 -

A school nurse is reinforcing teaching with an adolescent who has type 1 diabetes. Which of the following responses by the adolescent indicates and understanding of the teaching ?

A should eat extra food on busy days when I am more active A should increase my intake of sugar free fluids when I am sick A should eat a snack 30 minutes before my basketball games start

A nurse is assessing a client who is 85 years old. Which of the following findings should the nurse identify as a manifestation of a MI ?

Acute confusion

A nurse is about to administer topical nitroglycerin ointment to a client who has angina. Which of the following should the nurse take ?

Apply ointment using a dose measuring applicator

A nurse is collecting data from a client who is experiencing chest pain. Which of the following medications should the nurse expect to administer to suppress the aggregation of platelets?

Aspirin

A nurse is preparing to administer timolol eye drops to a client who has primary open angle glaucoma. Prior to administration the nurse should recognize that which of the following conditions in the clients medical history is a contraindication to receiving this medication ?

Asthma

A nurse is reinforcing teaching about UTI with a client. Which of the following manifestations should the nurse include ?

Back pain Urinary frequency Urgency Cloudy, foul smelling urine

A nurse is caring for a client who has a prescription for clopidogrel (Plavix). The nurse should monitor the client for which of the following adverse effects ?

Bleeding

A nurse is reviewing the laboratory values for a client who has HHS. The nurse should expect that which of the following lab values is consistent with HHS?

Blood glucose 320

A nurse is collecting data from an adolescent who takes insulin for the treatment of type 1 diabetes. The nurse should identify that which of the following findings indicates effective management of the clients diabetes

Blood glucose value at bedtime of 140 mg/dL

A nurse is reviewing the laboratory reports for a client and notes an elevated thyroid- stimulating hormone (TSH) level. When collecting data from the client, which of the following findings should the nurse expect ?

Bradycardia -high TSH indicates hypothyroidism-

A nurse is caring for a group of clients on a medical surgical unit. Which of the following disorders should the nurse identify as increasing the metabolic needs of the client ?

COPD Cancer Parkinson's disease Major burns

A nurse is reinforcing discharge teaching with a client who has venous thrombosis and a prescription for warfarin. Which of the following instructions should the nurse include in the teaching?

Carry a medical alert ID card

A nurse is reinforcing teaching with a client who has primary adrenal insufficiency (addisons disease) an a prescription for hydrocortisone. Which of the following statements should the nurse include the teaching about this medication ?

Carry a supply of pills and a single use injectable preparation with you at all times -The person should have emergency medication in case of times of unexpected stress

A nurse is reinforcing teaching with a client who has hypothyroidism and is taking levothyroxine. The nurse should instruct the client to report which of the following manifestations to the provider ?

Chest pain

A nurse is reinforcing teaching about a low cholesterol diet with a client who had a MI. Which of the following meal selections by the client indicates an understanding of the teaching ?

Chicken breast and corn on the cob

A nurse is collecting data from a child who is postoperative and received a unit of packed RBCs during a surgical procedure. Which of the following findings indicates the child is experiencing a hemolytic transfusion reaction

Chills and flank pain

A nurse is collecting stats from a preschooler who has HIV. Which of the following manifestations should the nurse expect ?

Chronic diarrhea

A nurse is reviewing the medical record of a client who might have hearing loss. Which of the following pieces of information from the clients medical record should the nurse identify as a risk factor for hearing loss ?

Chronic use of salicylates -aspirin can lead to ototoxicity

A nurse is collecting a urine specimen for culture and sensitivity for a client who has a urinary tract infection. The client has an indwelling urinary catheter in place. Which of the following actions should the nurse take ?

Clamp the tubing below the collection port

A nurse is collecting data from a client who has left sided heart failure. Which of the following findings should the nurse expect ?

Crackles in the lung bases

A nurse is collecting data from a client who is postoperative following a TURP. After the nurse discontinues the urinary catheter, which of the following findings should the nurse report to the provider

Decreased urinary output

The nurse is collecting data from a client who has right sided heart failure Which of the following findings should the nurse expect

Dependent edema

A nurse is preparing a client who has a brain tumor for CT scan. Which of the following factors affect the manner in which the nurse will prepare the client for the scan ?

Developed hives when eating shrimp (Allergy to shellfish is a contraindication for use of contrast media during CT scan)

A nurse is caring for a client who experienced a traumatic brain injury. Which of the following findings is an indication the client is experiencing ICP

Dilated pupils

Metoprolol discharge teaching

Dont not stop taking medication abruptly Count your radial pulse daily Change positions slowly

A nurse is caring for a client who has advanced heart failure Which of the following actions should the nurse take ?

Enforce fluid restriction

A nurse is caring for a client who has severely elevated blood pressure. Which of the following findings should the nurse identify as a manifestation of hypertension ?

Epistaxis (nosebleed)

A nurse is checking lab values to determine if a client who has diabetes mellitus is adhering to treatment plan. Which of the following tests should the nurse use to make this determination ?

Glycosylated hemoglobin levels (HbA1c)

A nurse is caring for a client who is postpartum. The nurse should identify which of the following findings as a manifestation of UTI

Hematuria

A nurse is collecting data on a client who has developed hypertension that is unresponsive to lifestyle changes. The client has no other comorbidities. Which of the following medications should the nurse expect the provider to prescribe ?

Hydrochlorothiazide

A nurse is collecting data from a client who has addisons disease. Which of the following findings should the nurse expect ?

Hypotension

A nurse in a providers office is collecting data from a client who has hypothyroidism and has been taking levothyroxine for 3 months. Which of the following statements by the client indicates that a decrease in the dosage might be needed ?

I am having trouble sleeping at night

A nurse is reinforcing dietary teaching with a client who has heart failure and is on a 2g sodium diet. Which if the following statements by the client indicates an understanding of the teaching ?

I can have yogurt as a desert

A nurse is caring for a client who has TB and is taking rifampin. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of this medication ?

I have noticed my urine is orange in color

A nurse is reinforcing teaching about ways to improve nutritional intake with a client COPD and has been losing weight. Which of the following statements by the client indicates an understanding of the teaching ?

I should add grated cheese to sauces and vegetables

A nurse is reinforcing teaching with a client who has COPD about maintaining proper nutrition. Which of the following statements by the client indicates an understanding of the teaching?

I will eat more cold foods at meals rather than hot foods

A nurse is reinforcing teaching with a client who has a new prescription for warfarin. Which of the following statements indicates that the client understands the instructions ?

I'll avoid contact sports like football

A nurse is caring for a client who is taking warfarin. Which of the following laboratory values should the nurse recognize as an effective response to the medication ?

INR 3.0

A nurse is assisting with caring for a client who has experienced a head injury from a fall at work. After checking the clients airway, breathing, and circulation (ABC's), which of the following actions is the priority for the nurse to perform ?

Immobilize the clients cervical spine

A nurse is caring for a client who has PVD and ulcers on the toes. Which of the following findings of PVD is a risk factor for ulceration of the extremities ?

Impaired circulation

A nurse is caring for a client who has a 20 year history of COPD and is receiving oxygen at 2L via nasal cannula. The client is dyspneic and has a oxygen saturation via pulse oximetry of 85%. Which of the following actions should the nurse take ?

Increase oxygen flow and request an ABG determination

A nurse is reinforcing teaching with a client who had type 2 diabetes. About a prescription for insulin lispro. Which is the following statements shoukd the nurse include in the teaching ?

Insulin lispro has an onset of 15 to 30 minutes

A nurse is collecting data from a client who had fluid volume overload resulting from a cardiovascular disorder, which of the following manifestations should the nurse expect ?

Jugular vein distention Moist crackles Increased heart rate

A nurse is collecting data from a client who is receiving a unit of whole blood. Which of the following findings should the nurse identify as a manifestation of a hemolytic transfusion reaction ?

Lower back pain

A nurse is assisting with the care of an infant after a myelomeningoceale repair. Which of the following is the priority postoperative action the nurse should take?

Measure the infants head circumference (Hydrocephalus is a complication of a myelomeningocele repair and it's monitored using head circumference measurements. Increased head circumference is an indication that the infant is at greatest risk for ICP.

A nurse is reinforcing teaching with a client who has COPD about dietary choices. Which of the following client selections indicate an understanding of the teaching ?

Meatballs smothered in sauce

A nurse is reinforcing teaching with the parents of a child who has rheumatic fever. Which of the following statements by a parent indicates an understanding of the teaching ?

My child may take aspirin for his joint pain

A nurse is caring for a client who is having a possible MI. Which of the following findings should the nurse identify as an associated manifestation of MI ?

Nausea

Indications of a MI

Nausea and vomiting Diaphoresis and dizziness Anxiety and feeling of doom

The nurse is examining the ECG of a client who is having an acute MI. The nurse should identify that elevated ST segments on the ECG indicate which of the following alterations ?

Necrosis

A nurse is assisting with the care of a client who reports crushing chest pain. The nurse reviews the clients ECG results and notes ST changes. Which of the following medications should the nurse administer ?

Nitroglycerin

A nurse is caring for a client who is taking a prescription or glucocorticoid adrenal replacement medication for the long term treatment of addisons disease. Which of the following findings indicates that the client is experiencing an adverse effect of the medication ?

Osteoporosis

A nurse is teaching a client who has type 1 diabetes mellitus about a new subcutaneous insulin infusion pump. Which of the following pieces of information should the nurse reinforce in the teaching ?

Plan to use a type of short duration insulin in the infusion pump

The MAR shows that a client is taking clopidogrel. Which of the following events should the nurse expect to be reported in the clients medical history ?

Recent MI

A nurse is caring for a client who has TN and is taking rifampin. The nurse should monitor the client for which of the following findings as the adverse effect of rifampin?

Red-tinged urine

A nurse is caring for a client who has continuous bladder irrigation following a TURP. Which of the following actions should the nurse take ?

Report viscous drainage with clots to the provider

A nurse is caring for an older adult client who has COPD and pneumonia. The nurse should monitor the client for which of the following acid-base imbalances ?

Respiratory acidosis

A nurse is assisting with planning a community campaign about seasonal influenza. Which of the following plans should be included as a secondary prevention strategy ?

Screening groups of older adults in nursing care facilities for early influenza manifestations

A nurse is caring for a client with type 1 diabetes mellitus who has a prescription to administer regular insulin subcut. Which of the following insulin durations should the nurse identify for regular insulin

Short duration, slow acting

The nurse is assisting with the preparation of an in service presentation about collecting data from client who are having acute MI. The nurse should identify that the most common finding of acute MI is which of the following ?

Substernal chest pain

A nurse is showing a client who has right sided heart failure an illustration of the heart. The nurse should identify the blood vessels that carry deoxygenated blood to the right atrium as which of the following ?

Superior vena cava

A nurse is collecting data about the respiratory status of a client who has COPD. Which of the following manifestations should the nurse identify as an indication of the early onset of respiratory failure ?

Tachycardia Dyspnea Restlessness Headaches High blood pressure

A nurse is caring for a client who had a thyroidectomy to treat hyperthyroidism cause by an adenoma. Which of the following findings should the nurse report to the provider ?

Tachycardia and hypertension Laryngeal stridor and hoarseness Positive trousseau's sign

A nurse is reinforcing teaching with a client who is taking levothyroxine to treat hypothyroidism and has a new prescription for a calcium supplement. Which of the following pieces of information should the nurse include in the teaching ?

Take the calcium supplement 4 hours apart from taking the levothyroxine

A nurse is evaluating the injection site for a client who had a mantoux skin test 48 hours ago. The nurse finds 10mm of induration with slight redness. Which of the following conclusions should the nurse make ?

The client has been exposed to TB

A nurse is collecting data from a client who has hypothyroidism and takes levothyroxine. Which of the following findings indicates that the client is experiencing acute levothyroxine overdose ?

Tremors - Think hyperthyroidism-

A nurse is reinforcing teaching with a client who has addisons disease about healthy snacks. Which of the following food choices by the client indicates an understanding of the teaching ?

Turkey and cheese sandwich -think low in potassium. The disease causes hyperkalemia-

How does variant angina compare to stable angina ?

Variant angina can cause changes in your electrocardiogram

A nurse is assisting in monitoring a client who had a myocardial infarction. For which of the following complications should the nurse monitor in the first 24 hrs?

Ventricular dysrhythmias

A nurse is collecting data from a client who has heart failure and is receiving digoxin. Which of the following findings should indicate to the nurse the client is experiencing digoxin toxicity ?

Visual disturbances

A nurse is caring for a client who takes warfarin 2.5 mg PO daily and has a INR of 6.2. The nurse should anticipate a prescription from the provider for which of the following medications ?

Vitamin K

A nurse is caring for a client who has late stage heart failure and is experiencing fluid volume overload. Which of the following findings should the nurse expect ?

Weight gain of 1kg (2.2lb) in 1 day

A nurse is collecting data from an older adult client who has right sided heart failure. Which of the following findings is the nurse's priority to report ?

Weight increase of 0.91 kg (2lb) in 24 hrs

A nurse is collecting data from a client following a recent head injury. Which of the following findings should the nurse recognize as a manifestation of ICP

Widened pulse pressure

A nurse is collecting data from a client following a recent head injury. Which of the following findings should the nurse recognize as a manifestation of ICP?

Widened pulse pressure Pupil changes Change of level in consciousness Nausea and vomiting

A nurse is reinforcing teaching with a female client who has pyelonephritis about the disorder. Which of the following pieces of information should the nurse include to help the client prevent a recurrence ?

Wipe from front to back after defecation

A nurse is reinforcing teaching about exercise with an adolescent client who has type 1 diabetes mellitus. Which of the following points should the nurse reinforce ?

You might need to decrease your routine insulin dosage before exercise

A nurse is reinforcing teaching to a client who is postpartum and has been prescribed warfarin therapy for DVT. Which of the following instructions should the nurse include ?

You will need to use a reliable form of contraceptives while on warfarin therapy

A nurse is reinforcing teaching with a client who has TB and a prescription for isoniazid. Which of the following instructions should the nurse include ?

Your provider will monitor your liver function while you are taking this medication

A nurse documents clubbing of the fingernails for a client who has emphysema. The nurse should identify that which of the following is the underlying cause of this finding ?

chronic hypoxemia