PN2 Exam 1

1. After teaching a patient who is being treated for dehydration, a nurse assesses the patient's understanding. Which statement indicates that the patient correctly understood the teaching?

a. I will weigh myself each morning before I eat or drink.

1. An older female patient has been prescribed esomeprazole (Nexium) for treatment of chronic gastric ulcers. What teaching is particularly important for this patient?

a. Increase intake of calcium and vitamin D

1. A nurse is assessing a patient who has acute pancreatitis and is at risk for an acid-base imbalance. For which manifestation of this acid-base imbalance would the nurse assess?

a. Kussmaul respirations

1. A nurse assesses a patient who is prescribed furosemide (Lasix) for hypertension. For which acid-base imbalance does the nurse assess to prevent complications of this therapy?

a. Metabolic alkalosis

1. A nurse is assessing patients on a medical-surgical unit. Which adult patient does the nurse identify as being at greatest risk for insensible water loss?

a. Anxious patient who has tachypnea

1. A nurse is caring for a patient who has just experienced a 90-s tonic-clonic seizure. The patient's arterial blood gas values are pH 6.88, PaO2 50 mm Hg, PaCO2 60 mm Hg, and HCO3- 22 mEq/L (22 mmol/L). What action would the nurse take first?

a. Apply oxygen by mask or nasal cannula.

1. The nurse is caring for a patient with peptic ulcer disease who reports sudden onset of sharp abdominal pain. On palpation, the patient's abdomen is tense and rigid. What action takes priority?

a. Notify the healthcare provider immediately

1. A nurse assesses a patient who is admitted with an acid-base imbalance. The patient's arterial blood gas values are pH 7.32, PaO2 85 mm Hg, PaCO2 34 mm Hg, and HCO3- 16 mEq/L (16 mmol/L). What action does the nurse take next?

a. Assess client's rate, rhythm, and depth of respiration.

1. A nurse is assessing a patient with hypokalemia, and notes that the patient's handgrip strength has diminished since the previous assessment 1 hour ago. What action does the nurse take first?

a. Assess the patient's respiratory rate, rhythm, and depth.

1. A nurse is assessing patients on a medical-surgical unit. Which patient is at risk for hypokalemia?

a. Patient with pancreatitis who has continuous nasogastric suctioning

1. The nurse caring for patients with gastrointestinal disorders would understand that which category best describes the mechanism of action of sucralfate (Carafate)?

a. Mucosal barrier fortifier

1. After teaching a patient who was malnourished and is being discharged, a nurse assesses the patient's understanding. Which statement indicates that the patient correctly understood teaching to decrease risk for the development of metabolic acidosis?

"I will eat three well-balanced meals and a snack daily."

1. A nurse teaches a patient who is at risk for mild hypernatremia. Which statement does the nurse include in this patient's teaching?

"Read food labels to determine sodium content."

1. A client with severe bacterial cystitis is prescribed cefadroxil (Duricef) and phenazopyridine (Pyridium). What statement by the client indicates an accurate understanding of these medications?

a. An orange color in my urine won't alarm me.

1. A nurse evaluates the following arterial blood gas values in a patient: pH 7.48, PaO2 98 mm Hg, PaCO2 28 mm Hg, and HCO3- 22 mEq/L (22 mmol/L). Which patient condition does the nurse correlate with these results?

a. Anxiety-induced hyperventilation

A client just experienced an episode of reflux with regurgitation. What assessment by the nurse is the priority?

Auscultate the lungs for crackles

1. A nurse assesses a patient who is experiencing an acid-base imbalance. The patient's arterial blood gas values are pH 7.34, PaO2 88 mm Hg, PaCO2 38 mm Hg, and HCO3- 19 mEq/L (19 mmol/L). Which assessment would the nurse perform first?

Cardiac and rhythm

Which client statement indicates a good understanding regarding antibiotic therapy for recurrent urinary tract infections?

Even if I feel completely well, I should take the medication until it is gone.

The female client's urinalysis shows all the following results. Which does the nurse document as abnormal?

Ketones bodies present

1. The nurse is caring for a client with an umbilical hernia who reports increased abdominal pain, nausea, and vomiting. The nurse notes high-pitched bowel sounds. Which conclusion does the nurse draw from these assessment findings?

a. Bowel obstruction; client should be placed on NPO status.

1. A nurse is caring for a patient who has the following arterial blood values: pH 7.12, PaO2 56 mm Hg, PaCO2 65 mm Hg, and HCO3- 22 mEq/L (22 mmol/L). Which clinical situation does the nurse correlate with these values?

a. Bronchial obstruction related to aspiration of a hot dog

1. A nurse is caring for a patient who has a serum calcium level of 14 mg/dL (3.5 mmol/L). Which provider order does the nurse implement first?

a. Connect the patient to a cardiac monitor.

1. After teaching a patient to increase dietary potassium intake, a nurse assesses the patient's understanding. Which dietary meal selection indicates that the patient correctly understands the teaching?

a. Sausage, one slice of whole-wheat toast, half cup of raisins (120 gm), and a glass of milk

1. A nurse assesses a patient who has appendicitis. Which clinical manifestation would the nurse expect to find?

a. Severe, steady right lower quadrant pain

A nurse is caring for a patient who is experiencing excessive diarrhea. The patient's arterial blood gas values are pH 7.18, PaO2 98 mm Hg, PaCO2 45 mm Hg, and HCO3- 16 mEq/L (16 mmol/L). Which provider order does the nurse expect to receive?

a. Sodium bicarbinate 100 mEq diluated in 1 L of D5W

1. A nurse is caring for a patient who is experiencing moderate metabolic alkalosis. What action would the nurse take?

a. Teach the patient fall prevention measures.

1. A patient has gastroesophageal reflux disease (GERD). The provider prescribes a proton pump inhibitor. About what medication would the nurse anticipate teaching the patient?

Omeprazole (Prilosec)

1. A client scheduled for intravenous urography (another term for pyelography...an X-ray technique for producing an image of the renal pelvis and urinary tract by the introduction of a radiopaque fluid.) informs the nurse of the following allergies. Which one does the nurse report to the health care provider immediately?

Seafood

1. A nurse prepares a patient for a colonoscopy scheduled for tomorrow. The patient states, "My provider told me that the fecal occult blood test was negative for colon cancer. I don't think I need the colonoscopy and would like to cancel it." How would the nurse respond?

a. "A negative fecal occult blood test does not rule out the possibility of colon cancer."

1. A patient at risk for developing hyperkalemia states, "I love fruit and usually eat it every day, but now I can't because of my high potassium level." How will the nurse respond?

a. "Berries, cherries, apples, and peaches are low in potassium."

1. A nurse is assessing patients for fluid and electrolyte imbalances. Which patient will the nurse assess first for potential hyponatremia?

a. A 34-year-old on NPO status who is receiving intravenous D5W

1. A nurse assesses patients at a community health center. Which patient is at highest risk for the development of colorectal cancer?

a. A 72-year-old who eats fast food frequently

1. A nurse cares for a patient newly diagnosed with colon cancer who has become withdrawn from family members. Which action would the nurse take?

a. Encourage the patient to verbalize feelings about the diagnosis.

1. A nurse assesses a patient with diabetes mellitus who is admitted with an acid-base imbalance. The patient's arterial blood gas values are pH 7.36, PaO2 98 mm Hg, PaCO2 33 mm Hg, and HCO3- 18 mEq/L (18 mmol/L). Which manifestation does the nurse identify as an example of the patient's compensation mechanism?

a. Increased rate and depth of respirations

1. A client's urinalysis results show a protein level of 1.8 mg/dl. Which action by the nurse is best?

a. Inform the health care provider

1. After hiatal hernia repair surgery, a patient is on IV pantoprazole (Protonix). The patient asks the nurse why this medication is given since there is no history of ulcers. What response by the nurse is best?

a. It prevents stress-related ulcers

1. A nurse is assessing a patient who has an electrolyte imbalance related to renal failure. For which potential complications of this electrolyte imbalance does the nurse assess? (Select all that apply.)

a. Electrocardiogram changes b. Paralytic ileus c. Skeletal muscle weakness

1. After teaching a patient who is prescribed a restricted sodium diet, a nurse assesses the patient's understanding. Which food choice for lunch indicates that the patient correctly understood the teaching?

a. Grilled chicken breast with glazed carrots

1. Which question best assisting the nurse in assessing a client with acute diarrhea?

a. Have you traveled outside the country recently?

1. A nurse is caring for a patient who has the following laboratory results: potassium 3.4 mEq/L (3.4 mmol/L), magnesium 1.8 mEq/L (0.74 mmol/L), calcium 8.5 mEq/L (2.13 mmol/L), and sodium 144 mEq/L (144 mmol/L). Which assessment does the nurse complete first?

a. Depth of respirations

1. The nurse is caring for a client who has just returned from abdominal surgery. When auscultation the client's abdomen, the nurse does not hear any bowel sounds. Which is the nurse's best action?

a. Document the finding.

After providing discharge teaching, a nurse assesses the patient's understanding regarding increased risk for metabolic alkalosis. Which statement indicates that the patient needs additional teaching?

a. I take sodium bicarbonate after every meal to prevent heartburn

1. Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a patient. Which statement by the patient indicates that the teaching about this medication has been effective?

a. I will drink apple juice instead of orange juice for breakfast

1. The client is scheduled for a colonoscopy. Which statement indicates that the client needs additional teaching about the procedure?

a. I will take my Coumadin with a sip of water tomorrow morning.

1. A nurse assesses a patient who is admitted for treatment of fluid overload. Which manifestations does the nurse expect to find? (Select all that apply.)

a. Increased pulse b. Distended neck veins c. Skeletal muscle weakness