CH1 all test questions

The nurse has been providing TB education to the patient. The nurse knows that teaching has been effective when the patient states which of the following? "My family does not need to get get tested too" "My family will not need to wear the mask when they visit me in the hospital" " I should not drink alcohol while taking TB medications" " after I take the antibiotics for 24 hours I can go to the cafeteria"

" I should not drink alcohol while taking TB medications"

A client with a subtotal gastrectomy is scheduled for discharge. Which instruction should the nurse give the client to reduce the possibility of dumping syndrome? "Be sure to eat foods high in complex carbohydrates." "It is helpful to take a walk after eating." "Don't lie down for at least 2 hours after eating." "Avoid drinking fluids with your meal."

"Avoid drinking fluids with your meal."

Which statement made by a client with chronic renal failure and who is on hemodialysis indicates the need for further teaching? "I take my prescribed antihypertensive drugs daily" "I will report any increase in my weight of 5 pounds in a 2-day period" "I am careful to take precautions in the arm with the AV fistula" "I comply with salt restrictions in my diet by using salt substitutes"

"I comply with salt restrictions in my diet by using salt substitutes"

A male patient returns to the clinic with a recurrent urethral discharge after being treated for a chlamydial infection 2 weeks ago. Which statement by the patient indicates the most likely cause of the recurrence of the disease? "I haven't told my girlfriend about my infection." "I have had a couple of beers while I was taking the medication." "I took my vibramycin twice a day for a week." "I've only had sex once since my medication was finished."

"I haven't told my girlfriend about my infection."

A 42-year-old patient recently developed abdominal distention, weight loss, steatorrhea, and flatulence. A diagnosis of adult celiac disease is made, and treatment is initiated. The nurse identifies that teaching about the treatment of the disease has been effective when the patient says "A course of antibiotics is usually effective in treating this disorder." "To control the fatty, greasy stools, I should eat only very low-fat or fat-free foods." "I must take maintenance folic acid for the rest of my life." "I must avoid all sources of wheat, rye, and oats in my diet."

"I must avoid all sources of wheat, rye, and oats in my diet."

Mr. Davis is an asthmatic who is being discharged from the urgent care unit. His wheezing has improved. The nurse know that Mr. Davis understands his discharge instructions if he says "I should rinse my mouth out after I use the long acting steroid inhaler ". "I wait 25 minutes between my inhalation puffs". "I will able able to discontinue my medication once my asthma is controlled". " Quitting smoking is not needed with asthma".

"I should rinse my mouth out after I use the long acting steroid inhaler ".

What statement made by a client with polycystic kidney disease indicates that the desired outcome has been met? The development of the renal failure with this disease is very rare" "I will have my family seek genetic counseling and screening" "I sure am glad that hemodialysis will shrink the cysts" "I know these drugs will make the cysts disappear"

"I will have my family seek genetic counseling and screening"

What statement made by a client with polysystic kidney disease indicates that the desired outcome has been met? "I know these drugs will make the cysts disappear" "I sure am glad that hemodialysis will shrink the cysts" "I will have my family seek genetic counseling and screening" "The development of the renal failure with this disease is very rare"

"I will have my family seek genetic counseling and screening"

A patient with epilepsy is started on phenytoin (Dilantin®) to prevent recurrent seizure activity. Which statement by the patient indicates understanding of the teaching about this medication "I will not have seizures since I am on the medicine". "I will not need to have my blood drawn to check that the drug level is therapeutic". "I will need to be very careful to perform good oral hygiene." "I will take the medication only if I feel the aura of a seizure".

"I will need to be very careful to perform good oral hygiene."

The nurse knows that the patient understands how blood and Rh factor typing helps with deciding which blood type to administer to a patient, when the patient states: "If I am O blood type, I can receive blood from all types" "If I am AB blood type, I can donate blood and everyone can receive my blood" "If I am Rh negative, I can only receive Rh negative blood" "If I am Rh positive, I can only receive Rh positive blood"

"If I am Rh negative, I can only receive Rh negative blood"

A patient planning to be married tells the nurse that she has a strong family history of Huntington's Disease but does not plan to let her fiancé know. How should the nurse respond? "Is there any reason you do not want your fiancé to know about your genetic illness?" "It is probably best that he is not aware of the disease." "Are you afraid he will not want to marry you if he knows?" "There are worse disease processes than Huntington's Disease."

"Is there any reason you do not want your fiancé to know about your genetic illness?"

The nurse takes an informed consent document to the patient's room in preparation for an emergency surgical procedure. The patient states, "Doc said he would tell me all about the surgery when he gets here. Do you know what they are going to do?" What is the nurse's best response? "Go ahead and sign this so we will have that part done when the physician gets here." "Let's wait on signing this until your physician has talked to you." "I am not certain; let me call the nursing supervisor to explain it to you." "Let me go get a medical surgical textbook so I can use the pictures to explain the procedure."

"Let's wait on signing this until your physician has talked to you."

A diabetic patient complains of frequent corns and asks for information about managing the condition. What is the nurse's best response? "Make sure you select shoes that fit correctly." "Apply a generous amount of emollient lotion on and between the toes twice daily." "You can use corn pads to gradually remove the growths." "Corns are best treated by shaving them off."

"Make sure you select shoes that fit correctly."

A client will undergo scratch tests for allergies. In teaching the client about the planned tests, the nurse should include which statement? "This test allows us to rule out one or two specific antigens." "It involves drawing a small amount of blood for testing." "Results can be obtained in 30 minutes." "The scratch test is the most sensitive allergy test."

"Results can be obtained in 30 minutes."

The wife of a patient who has undergone a TURP and has continuous bladder irrigation asks the nurse whether the irrigation can be stopped because it seems to increase her husband's pain. The nurse's best response to the patient's wife is "The bladder irrigation is needed to stop the bleeding in the bladder." "Normal production of urine is maintained with the irrigations until healing occurs." "Antibiotics are being administered into the bladder with the irrigation solution to prevent infection." "The irrigation is needed to keep the catheter from being occluded by blood clots."

"The irrigation is needed to keep the catheter from being occluded by blood clots."

A client with chronic renal failure asks the nurse why he is anemic. What response by the nurse is best? "The increase metabolic waste products in your body depress the bone marrow" "There is a decreased production by the kidneys of the hormone erythropoietin" "We will need to review your dietary intake of iron-rich foods" "It is most likely that you have hereditary traits for the development of anemia"

"There is a decreased production by the kidneys of the hormone erythropoietin"

A client who has been diagnosed with idiopathic pulmonary fibrosis says, "I don't know what to expect. How will this disease affect my life?" Which nursing response is correct? "As long as you stay on your medication, the disease should not have a serious impact on how you live your life." "There really isn't a cure for this disease. You will have to work to manage symptoms as they arise." "There is no treatment for this disease, but it will go away on its own in the next few months. Then you will feel the same as you did before you got sick." "You will be pretty sick until you have surgery, but then you should feel well within 2 or 3 weeks."

"There really isn't a cure for this disease. You will have to work to manage symptoms as they arise."

Which statement by the patient undergoing external beam radiation indicates the need for further teaching? "this therapy will hopefully decrease the size of my tumor" "I will have daily radiation treatments for several weeks" "at least this procedure will not be painful" "my grandchildren will not be able to visit because I will be radioactive"

"my grandchildren will not be able to visit because I will be radioactive"

The nurse is preparing to administer a unit of packed red blood cells (PRBCs). When obtaining the necessary supplies, the nurse should obtain which IV solution to hang with the unit of blood? 5% dextrose in 0.45% sodium chloride 0.9% sodium chloride 5% dextrose in 0.9% sodium chloride Ringer's lactate

0.9% sodium chloride

How many spinal nerves are in the cervical column? 8 12 7 5

8

Which clients would the nurse assess as being at risk for nutritional imbalance due to physiologic stress? Select all that apply. A client who is undergoing a total colectomy A client admitted for nephritises A client undergoing aggressive chemotherapy for metastatic cancer A client who had a laparoscopic appendectomy this morning A client who sustained multiple fractures and rollover motor vehicle accident

A client who is undergoing a total colectomy A client undergoing aggressive chemotherapy for metastatic cancer A client who sustained multiple fractures and rollover motor vehicle accident

The nurse is caring for a patient receiving peritoneal dialysis. After completing the exchange and draining the dialysate, the nurse observes the dialysate is cloudy. How should the nurse evaluate this finding? A sign of infection The normal appearance of dialysate A sign of vascular access occlusion A sign of possible bowel perforation

A sign of infection

When a patient's airway becomes obstructed, which sign will the nurse see first? A sudden change in mentation A decrease in urine output The patient's hands become cold Pallor changing to cyanosis

A sudden change in mentation

The nurse is performing the morning assessment on Frank, a 7-year-old client. Frank stares off into space for a few seconds and does not seem to hear the nurse as she says his name. A few seconds pass, then Frank continues as if nothing happened. Which type of seizure is this child experiencing? Myoclonic seizure Absence seizure Tonic-clonic seizure Atonic seizure

Absence seizure

The nurse is caring for a client who has a urinary tract infection. The client reports pain and a burning sensation upon urination, and cloudy urine with an odor. Which of the following is a priority intervention by the nurse? Recommend drinking cranberry juice. Administer an antibiotic Offer a warm sitz bath. Encourage increased PO fluids

Administer an antibiotic

After an Ischemic Stroke, the patient is placed on Warfarin (Coumadin) and is asking about further clarification regarding vitamin K consumption. The nurses best response is: Alert your provider if you are increasing your vitamin K intake so they can increase your INR monitoring As long as the food with vitamin K in it is cooked, then you do not have to worry about how much you consume Do not increase your vitamin K intake as it as an antidote to the medication It is important to eat a heart healthy diet that includes all your vitamins and minerals, so please make sure you are consuming at least one salad a day

Alert your provider if you are increasing your vitamin K intake so they can increase your INR monitoring

The nurse is explaining what the ABG results mean to the client. How does the nurse explain an arterial pH of 7.47? Alkalosis Compensation Acidosis Homeostasis

Alkalosis

Pause for the Cause, also known as STO (surgical time out) is a Joint Commission Universal Protocol aimed at preventing wrong- surgery, wrong-site, and/or wrong-person surgery is compatible with which of the following statements: This procedure is by the scrub nurse and circulating nurse just before the first incision Pause for the Cause or STO places responsibility for wrong site/procedure/patient solely with the individual surgeon This procedure is done just after the induction of anesthesia All personnel in the operating room stop what they are doing to pay attention to the identification of patient, procedure, and site

All personnel in the operating room stop what they are doing to pay attention to the identification of patient, procedure, and site

A patient tells the nurse he has a "cold" every spring that lasts for 8 to 10 weeks. The nurse suspects that the patient is experiencing which condition? Vasomotor rhinitis Acute viral rhinitis Atrophic rhinitis Allergic rhinitis

Allergic rhinitis

A patient recovering from an acute exacerbation of rheumatoid arthritis (RA) tells the nurse she is too tired to bathe. The nurse should: Give the patient a bath. Allow the patient to rest before showering. Tell the patient that a cold shower will help reduce the inflammation. Tell the patient that excessive resting will result in skin breakdown.

Allow the patient to rest before showering.

When a patient is experiencing hypotension in the PACU, what are some of the assessments that the nurse would expect to see in addition to the hypotension? An increased heart rate and warm flushed skin A decreased heart rate and warm flushed skin A decreased heart rate and cold, clammy, pale skin An increased heart rate and cold, clammy, pale skin

An increased heart rate and cold, clammy, pale skin

During the course of a surgical procedure, the patient's heart rate increases and the blood pressure drops. Which care provider would address these physiological changes? Anesthesiologist Registered nurse first assistant (RNFA) Scrub nurse Surgeon

Anesthesiologist

A patient suffers a stroke with left hemisphere damage. Which of the following deficits does the nurse anticipate? Aphasia All of the above Left sided weakness Impulsivity and denial of deficits

Aphasia

During a surgical procedure, the patient begins to demonstrate signs of malignant hyperthermia. The nurse would expect to participate in which actions in the care of this patient? Provide 21% oxygen Hydrate by increasing oral intake Apply a cooling blanket Administer calcium-channel blockers

Apply a cooling blanket

A 22-year-old client with quadriplegia is apprehensive and flushed, with a blood pressure of 210/100 and a heart rate of 50 bpm. Which of the following nursing interventions should be done first? Instruct the patient to "bear down" to stimulate the vagus nerve Place the client flat in bed Notify the physician Assess patency of the indwelling urinary catheter

Assess patency of the indwelling urinary catheter

The nurse is admitting a client diagnosed with protein-calorie malnutrition secondary to AIDS. Which intervention should be the nurse's first intervention? Place in contact isolation and don a mask and gown before entering the room. Teach the client about total parenteral nutrition and monitor the subclavian. Assess the client's body weight and ask what the client has been able to eat. Check the orders and determine what laboratory tests will be done.

Assess the client's body weight and ask what the client has been able to eat.

Impaired physical mobility is a major nursing diagnosis for clients with osteoarthritis (OA). The nursing intervention best directed toward addressing this client's limitation is: Assessing the client's range of motion of affected joints in order to plan and implement appropriate interventions. Encouraging client to assume responsibility for personal self-care needs in order to retain ability to be physically active. Encouraging consistently high activity levels in order to minimize the development of associated emotional and self-esteem problems. Assessing and managing the client's need for narcotic analgesiscs in order to minimize the impact that pain has on personal activities of daily living.

Assessing the client's range of motion of affected joints in order to plan and implement appropriate interventions.

The nurse is providing discharge education for a patient who experienced an anaphylactic reaction to a bee sting. To ensure that the patient receives prompt, appropriate medical care in the event of another bee sting, the nurse encourages which actions? Select all that apply. Be able to identify early symptoms of allergic reaction. Wear a medical alert bracelet that identifies allergy to bee venom. Always have quick access to an epinephrine pen. Carry oral antihistamines at all times. Be aware of how quickly the symptoms occur and exacerbate.

Be able to identify early symptoms of allergic reaction. Wear a medical alert bracelet that identifies allergy to bee venom. Always have quick access to an epinephrine pen. Be aware of how quickly the symptoms occur and exacerbate.

Which of the following therapies improves long-term prognosis in multiple sclerosis? Anticholinergic drugs Beta-interferon Corticosteroids Anti-spasmodics

Beta-interferon

Which type of the following oral hypoglycemic medication should be held for 48 hours after a CT with contrast? Biguanide (Metformin) Methimazole (Tapazole) Sulfonylureas (Glyburide) Metadol (Methadone)

Biguanide (Metformin)

A nurse is admitting a client who reports nausea, vomiting, and weakness. Upon assessment, the client has dry oral mucous membranes, temperature 38.5 C (101.3 F), pulse 92/min, respiration 24/min, skin cool with tenting present, and blood pressure 102/ 64 mm Hg. His urine is concentrated with a high specific gravity. Which of the following is not a clinical manifestation of fluid volume deficit? Decreased skin turgor Bradycardia Concentrated urine Low-grade fever

Bradycardia

The nurses caring for patients receiving radiation therapy for esophageal cancer. Which manifestations should the nurse immediately report to the healthcare provider? Weight loss Difficulty swallowing solid food Bright bleeding from the mouth Crackles in the base of the lungs

Bright bleeding from the mouth

The client with diabetes mellitus requests a medication for headache soon after returning from an early morning x-ray procedure. The nurse observes the client is upset about the headache, angry at missing breakfast, and has moist hands. What priority action should the nurse take at this time? Acknowledge his dissatisfaction, offer to obtain a snack, and give the medication. Administer the medication for headache and arrange for a breakfast tray. Administer the headache medicine and review the day's lab test results. Check the blood glucose level and be prepared to give 4 ounces of juice immediately.

Check the blood glucose level and be prepared to give 4 ounces of juice immediately.

A client presents with dyspnea, pruritis, and localized swelling of the forearm after being stung by a bee. What is the priority nursing intervention? Check the tongue for swelling and listen for stridor Place the client in the Trendelenburg position Keep the client warm with soft blankets Remove the stinger from the client's arm

Check the tongue for swelling and listen for stridor

A client presents with dyspnea, pruritis, and localized swelling of the forearm after being stung by a bee. What is the priority nursing intervention? Place the client in the Trendelenburg position Remove the stinger from the client's arm Keep the client warm with soft blankets Check the tongue for swelling and listen for stridor

Check the tongue for swelling and listen for stridor

Patient has heard of several friends being diagnosed with colon cancer and does not want to develop the same health problem. Which should the nurse recommend to the patient? Select all that apply. Consume a diet high in fruits and vegetables and low in saturated fats and red meat. Participate in regular exercise Drink two servings of red wine everyday Maintain a healthy weight Obtain recommended screenings after the age of 50

Consume a diet high in fruits and vegetables and low in saturated fats and red meat. Participate in regular exercise Maintain a healthy weight Obtain recommended screenings after the age of 50

The nurse knows that the patient is exhibiting ____________ when the patient wakes up with hyperglycemia without prior hypoglycemia because the patient has the growth hormone secreted at night. Prediabetes Somogyi effect Dawn Phenomenon Nocturnal hyperglycemia

Dawn Phenomenon

A postoperative client is to receive a transfusion of platelets because of a critically low platelet count. What knowledge should the nurse have related to the function of platelets? Prevents formation of deep vein thrombosis Improves hemoglobin and hematocrit levels Returns prothrombin time to expected range Decreases bleeding from a surgical site

Decreases bleeding from a surgical site

The client diagnosed with myasthenia gravis is being discharged home. Which intervention has priority when teaching the client's significant others? Discuss ways to help prevent choking episodes Explain how to care for a client on a ventilator Teach how to perform passive range-of-motion exercises Demonstrate how to care for the client's feeding tube

Discuss ways to help prevent choking episodes

The nurse knows the following is true regarding Amyotrophic Lateral Sclerosis (ALS)? Discuss with the patient the importance of a living will Communicate early about caregiver support This is a disease of basal ganglia It is pertinent to discuss memory deficits Communicate ways to manage nutrition deficits Diagnosis is made with an MRI

Discuss with the patient the importance of a living will Communicate early about caregiver support Communicate ways to manage nutrition deficits

A nurse is caring for a client who has a laboratory finding of serum potassium 5.7 mEq/L. The nurse should assess for which of the following clinical manifestations? Polyuria Constipation Hypotension EKG changes

EKG changes

The nurse is preparing teaching for patient with gastroesophageal reflux disease (GERD) . What should this teaching include? Select all that apply. There is no treatment for this disease. Starting proton pump inhibitor once the symptoms are relieved. Elevate the head of the bed on 6 to 8 inch blocks. Peppermint and chocolate candies can help relieve symptoms. Avoid lying down for several hours after eating.

Elevate the head of the bed on 6 to 8 inch blocks. Avoid lying down for several hours after eating.

When caring for a male client with diabetes, the nurse assesses for which of the following chronic complications of diabetes? Hypoglycemia Erectile dysfunction Diabetic ketoacidosis Icteric sclera

Erectile dysfunction

Which of the following symptoms of infection in a patient with neutropenia who is one day post-op should cause the nurse to take immediate action? Fever of 100.5 Fo Swelling in the surgical area Complaints about a dry mouth Oozing from the surgical site

Fever of 100.5 Fo

A client contacts the nurse and describes some soft movable masses she felt in her breasts that become enlarged during menstruation. The nurse should be aware that the client is most likely describing: Fibrocystic changes of the breast Fibroids of the breast Cancer of the breast Hyperplasia of the breast

Fibrocystic changes of the breast

The nurse returns to evaluate a client whose blood transfusion has been infusing for 30 minutes. Upon assessment, the nurse notes that the client is dyspneic and auscultates the presence of crackles in the lung bases with an apical heart rate of 110 beats per minute. What complication should the nurse suspect that the client is experiencing? Hypovolemia Fluid overload Immune response to transfusion Polycythemia vera

Fluid overload

Which of the following are methods of describing/assessing a patient's level of consciousness? Select all that apply. GCS NIH Stroke Scale CBC A + O x 4

GCS NIH stroke scale A + O x4

What is the highest priority in performing a neurological assessment? Getting a baseline assessment Obtain the past medical history Make sure the patient has equal strength bilaterally Check pupillary response every hour

Getting a baseline assessment

The nurse understands that which type of insulin has the longest duration of action? Glargine (Lantus) Aspart (Novolog) Regular (Novolin R) NPH (Novolog mix 70/30)

Glargine (Lantus)

A patient who had a bone marrow transplant 10 days ago develops a maculopapular rash on the palms of both hands and the soles of the feet. The patient complains of severe abdominal pain with bloody diarrhea. The nurse would anticipate providing care for which condition? Chronic graft rejection Acute tissue rejection Hyperacute tissue rejection Graft-versus-host disease

Graft-versus-host disease

The nurse cares for a patient with suspected cancer of the bladder. The nurse knows that which of the following findings is MOST common in a patient with a diagnosis of cancer of the bladder? Left flank pain Hematuria Potassium of 5.9mEq/L Painful urination

Hematuria

A nurse is monitoring for postoperative complications in a client who had a kidney biopsy. Which of the following complication causes the most immediate risk to the client? Kidney Failure Infection Hemorrhage Hematuria

Hemorrhage

The nurse caring for a client undergoing hemodialysis procedure places high priority on evaluating the client frequently for what common complication during the treatment? Hypotension Hyperglycemia Dialysis dementia Infection and fever

Hypotension

The nurse understands oxygen therapy for a patient with COPD requires close monitoring because of which of the following? Hypoxic respiratory drive Hypercapneic respiratory drive Alkalotic respiratory drive Acidotic respiratory drive

Hypoxic respiratory drive

A patient with diabetes mellitus has the flu and is not able to keep his food down. The nurse knows the patient needs more teaching when the patient states: I don't need to take my Metformin (Glucophage) because I haven't eaten and my blood sugar is going to be low I should try to drink some extra water I should try to find something to eat, so my blood sugar doesn't get too low I can take my Tamiflu (Oseltamivir) without worrying that it will affect my blood glucose

I don't need to take my Metformin (Glucophage) because I haven't eaten and my blood sugar is going to be low

You are providing discharge instructions for your patient with Benign Paroxysmal Positional Vertigo (BPPV). Which statement indicates the patient understanding BPPV management? I should use two pillows in bed, and get up slowly in the morning. I should lie flat in bed and lie on my affected side. I should lie flat in bed, and sit up slowly in the morning. I should use two pillows in bed and lie on my affected side

I should use two pillows in bed, and get up slowly in the morning.

The nurse is discussing the long-term care of a child with cystic fibrosis (CF) with the parents. Which goals should the nurse include in this plan? Maintaining antibiotic therapy to cure the disease Improvement of nutrition Preventing common neurologic complications Assure the patient understands the importance of using braces to walk

Improvement of nutrition

A patient is suspected of having iron deficiency anemia (IDA). Which laboratory value would the nurse evaluate as supporting this diagnosis? Select all that apply High hematocrit level Increased total iron binding capacity (TIBC) Hyperchromic cells on indices Low levels of serum transferrin High neutrophil count

Increased total iron binding capacity (TIBC) Low levels of serum transferrin

A health care provider prescribes duloxetine (Cymbalta) for a client diagnosed with fibromyalgia. The nurse anticipates that this medication is being prescribed for what reason? Increases serotonin and norepinephrine levels Relaxes client and promotes sleep Reduces neuropathic pain Decreases swelling to joints

Increases serotonin and norepinephrine levels

While assessing a client's IV line, the nurse notes that the area is swollen, cool, pale, and causes the client discomfort. What complication should the nurse document? Infiltration Air embolism Infection Phlebitis

Infiltration

Phlebitis is defined as: Formation of a blood clot within the vein Inadvertent administration of nonvesicant solutions or medications into surrounding tissues Inflammation of the vein's tunica intima An inadvertent administration of a solution or medication into the surrounding tissues

Inflammation of the vein's tunica intima

A nurse is planning care for a client to prevent postoperative atelectasis. Which of the following interventions should the nurse include in the plan of care? Select all that apply. Encourage the use of incentive spirometry every 2 hours Instruct client to splint incision when coughing and deep breathing Reposition the client every 2 hours Administer antibiotic therapy Assist with early ambulation

Instruct client to splint incision when coughing and deep breathing Reposition the client every 2 hours Assist with early ambulation

A patient's serum potassium is 2.2 mEq/L. Which nursing action is the highest priority for this patient? Correct! Intiate cardiac monitoring Intiate seizure precuations Administer Sodium polystrene (Kayexalate) as prescribe Start oxygen at 2L/ min

Intiate cardiac monitoring

Torsion of the testes requires immediate surgical correction because: Irreversible damage occurs after a few hours There is no other way to control pain The reduction in testicular blood flow leads to rapid death of sperm Swelling is excessive and the testicle may rupture

Irreversible damage occurs after a few hours

A client with gastroesophageal reflux disease (GERD) is prescribed famotidine (Pepcid). In order to provide effective teaching, the nurse must include which information about the action of the drug? It increases the gastric pH. It improves gastric motility. It coats the distal portion of the esophagus. It decreases the secretion of gastric acid.

It decreases the secretion of gastric acid.

The nurse is assessing a patient with COPD for evidence of cor Pulmonale. Which of the following findings could indicate the presence of cor Pulmonale? Jugular vein distension Left ventricular hypertrophy Bibasalar crackles Cyanosis

Jugular vein distension

A nurse on the medical-surgical unit has identified safety as a priority problem for a client who is in the later stages of Alzheimer disease. The client is awake at night and tends to wander. Which interventions would the nurse use in the care of this client? Select all that apply Keep a nightlight on in the room. Restrain the client at the beginning of the shift. Take the client to the bathroom every 2 hours. Keep the client's room free of clutter and unnecessary items. Place nonskid slippers on the client.

Keep a nightlight on in the room. Take the client to the bathroom every 2 hours. Keep the client's room free of clutter and unnecessary items. Place nonskid slippers on the client.

A 75-year-old patient is received into the postanesthesia recovery room (PACU) following a 6-hour abdominal surgery. The patient's hemodynamic status is stable. Based on knowledge of the patient's surgery and the common postoperative complications the patient might be at risk for, the recovery room nurse would perform which interventions? Keep the room temperature at 75 degrees, consider supplemental oxygen, and provide warm blankets. Assess the patient's blood pressure more frequently than for younger clients and provide oxygen. Consider increasing the IV fluids, assess for urine output, and monitor the oxygen saturation. Provide postoperative instructions to avoid straining and eat a low-fiber diet.

Keep the room temperature at 75 degrees, consider supplemental oxygen, and provide warm blankets.

Which of the following food choices made by a client with anemia best indicates that the nurse's instructions about foods high in iron has been successful? Oranges and grapefruits Eggs, milk, and milk products Liver and muscle meats Spinach and broccoli

Liver and muscle meats

Generalized seizures are different from partial seizures in that generalized seizures arise from multiple foci in both hemispheres of the brain and are often accompanied by what? Lip smacking, chewing, or pulling at clothing Disturbances in hearing, sight, or taste Loss of consciousness Seeing spots (aura)

Loss of consciousness

A client newly diagnosed with diverticulosis is being discharged. The client asks the nurse what type of diet may have contributed to the diagnosis. What is the best response by the nurse? Low-carbohydrate diet High-protein diet Low-fiber diet HIgh-fiber diet

Low-fiber diet

The nurse understands that the goal of a renal diet includes which of the following? Lowered intake of amino acids to decrease triglycerides and serum albumin Lowered intake of sugars to decrease blood glucose Lowered intake of protein to decrease blood urea nitrogen (BUN) Lowered intake of fats to decrease blood triglycerides

Lowered intake of protein to decrease blood urea nitrogen (BUN)

The nurse is caring for a female client with new diagnosed breast cancer. The patient is being prepared for surgery to remove the lump, the patient ask why the axilla lymph nodes will be biopsied. What is the nurses best response? Lymph nodes near the tumor are tested to see if there is evidence that the cancer has spread beyond the breast. Lymph node testing helps to determine the 5 year survival for cancer patients It is routine to test the neighboring lymph nodes but not to worry the tumor is small and probably hasn't spread. The results of the biopsy will determine how long your radiation treatments will last.

Lymph nodes near the tumor are tested to see if there is evidence that the cancer has spread beyond the breast.

When teaching a patient with diverticulosis about management of the condition, the nurse stresses that it is most important to: Use prophylactic antibiotics to prevent infection of diverticuli Maintain a high-fiber diet and high fluid intake Take daily laxatives to prevent constipation Avoid NSAID medication that may cause an increase in inflammation

Maintain a high-fiber diet and high fluid intake

The nurse is admitting a client with the diagnosis of Parkinson's disease. Which assessment data supports this diagnosis? Masklike facies and a shuffling gait Muscle weakness in the upper extremities and ptosis Crackles in the upper lung fields and jugular vein distention Exaggerated arm swinging and scanning speech

Masklike facies and a shuffling gait

A patient is being treated for an intestinal obstruction. The nurse inserts a nasogastric tube and attaches it to low continuous suction. Which acid base imbalance is the patient at risk for? Respiratory alkalosis Metabolic acidosis Metabolic alkalosis Respiratory acidosis

Metabolic alkalosis

A patient's blood gas show a pH of 7.53 and bicarbonate level of 36 mEq/L. The nurse prepares to treat this patient for which acid-base disorder? Respiratory alkalosis Metabolic alkalosis Respiratory acidosis Metabolic acidosis

Metabolic alkalosis

A nurse is planning care for a client who has chronic kidney disease. Which of the following should the nurse include in the plan of care? Select all that apply Monitor daily weights Encourage compliance with fluid restriction. Monitor for constipation. Monitor intake and output. Instruct on restricting calories from carbohydrates.

Monitor daily weights Encourage compliance with fluid restriction. Monitor for constipation. Monitor intake and output.

The nurse is caring for a patient after a breast biopsy. The MOST important nursing action following any biopsy is to: Carefully transport the specimen to the lab Apply ice to the area Reposition the patient for comfort Observe for bleeding

Observe for bleeding

The nurse instructs the client recently diagnosed with type 1 diabetes about proper meal planning. Which action should the nurse take first? Teach the client how to use the Exchange List for Meal Planning. Obtain a diet history that includes the client's favorite foods and usual meal patterns. Inform the client that 50-60% of calories should come from carbohydrates. Instruct the client about the importance of eating regular meals.

Obtain a diet history that includes the client's favorite foods and usual meal patterns.

In contrast to diverticulitis, the patient with diverticulosis Frequently develops peritonitis Often has no symptoms Has rectal bleeding Has localized cramping pain

Often has no symptoms

Which of the following changes is expected by the nurse in the urine of a patient diagnosed with renal failure? Oliguria Polyuria Dysuria Hematuria

Oliguria

The nurse assesses the arm of a patient with an arteriovenous fistula for the presence of which two findings? Hear a thrill and palpate radial pulse Palpate a thrill and hear a bruit A +3 radial pulse and capillary refill time <3 sec Palpate the bruit and check capillary refill time

Palpate a thrill and hear a bruit

The nurse is preparing patients newly diagnosed with diabetes mellitus (DM) for discharge from an acute care facility. What should the nurse include in patient teaching regarding medications to treat DM? Type 1 diabetes may progress to type 2 if blood glucose levels are not well controlled. Patients with type 1 diabetes will always need an exogenous source of insulin. Patients with type 2 diabetes generally need a combination of oral medications and insulin to achieve normal blood glucose levels. Patients with type 1 diabetes may achieve normal blood glucose levels with oral medications.

Patients with type 1 diabetes will always need an exogenous source of insulin.

The nurse is providing discharge teaching for a patient who was hospitalized for an exacerbation of chronic bronchitis. Which of the following points should the nurse not include in the teaching? Increase fluid intake Report fever or change in sputum to healthcare provider Perform 60 minutes of cardio 5X a week Complete all prescribed antibiotics

Perform 60 minutes of cardio 5X a week

The nurse recognizes that which factor in a patient's history increases the risk for type 2 diabetes mellitus (DM)? Body mass index of 23 Physical inactivity Low waist-to-hip ratio Blood pressure of 130/80

Physical inactivity

A nurse should be aware that benign prostatic hypertrophy (BPH): Predisposes to hydronephrosis Is a congenital abnormality Causes an elevated acid phosphatase Usually become malignant

Predisposes to hydronephrosis

A patient is suspected of having an allergic reaction to certain laundry detergents. The nurse recognizes that which diagnostic test result would best confirm a hypersensitivity reaction? Rh antigen with negative results Eosinophil of 2% of the total WBC Indirect Coombs' showing no agglutination Prick test with 3 mm erythema

Prick test with 3 mm erythema

The nurse is planning care for a patient with muscular dystrophy. What should the nurse include? Select all that apply. Assisting with pain management Educating the client about current curative options Promoting independence Providing psychological support

Promoting independence Providing psychological support

A patient diagnosed with HIV/AIDS has developed pneumonia and is bedbound. Which nursing interventions should be planned? Select all that apply. Suction the oral cavity, but avoid tracheal suctioning. Provide for periods of uninterrupted rest. Maintain fluid intake of 3 liters daily unless contraindicated. Elevate the head of the patient's bed at least 30 degrees. Turn the patient every 2 hours.

Provide for periods of uninterrupted rest. Maintain fluid intake of 3 liters daily unless contraindicated. Elevate the head of the patient's bed at least 30 degrees. Turn the patient every 2 hours.

Which of the following are ways for the nurse to recommend decreasing the risk for lung cancer? Low fat diet Annual chest x-ray screening Quit smoking 60 minutes of aerobic exercise, 5X a week

Quit smoking

A patient has undergone a mastectomy for breast cancer. The nurse determines that the patient is having the most difficulty adjusting to the loss of her breast when Refuses to look at the dressing Reads the post op care booklet Requests pain medicine when needed Performs arm exercises

Refuses to look at the dressing

The client receiving 5% dextrose and 0.45% sodium chloride intravenously and is complaining of pain at the IV site. The nurse assesses the site and notes erythema and edema. What is the appropriate action for the nurse to take? Select all that apply. Gently pull back on the IV catheter to attempt repositioning Slow the infusion to an keep-open rate Apply antibiotic ointment to the IV site Relocate the IV site and document the event Discontinue the IV and apply a warm compress to the IV site

Relocate the IV site and document the event Discontinue the IV and apply a warm compress to the IV site

An 81-year-old woman who lives alone is in the clinic for an annual physical. She reports that she has noticed that her sense of smell is not as acute as it used to be. Which nursing interventions are indicated? Recommend that the patient limit the amount she drives her car Ask the patient if she has a cat or dog living in her house Remind the patient of the need to change batteries in her smoke detectors twice a year Suggest that the patient use fewer spices when cooking

Remind the patient of the need to change batteries in her smoke detectors twice a year

A 61 year old client is admitted with pneumonia. Her ABG results are pH 7.46, PaO2 94, PaCO2 30, HCO3 19, and SaO2 72%. The nurse interprets this as: Metabolic Alkalosis Respiratory Alkalosis Respiratory Acidosis Metabolic Acidosis

Respiratory Alkalosis

The school nurse is assessing a teenage client who is anxious and presents with an increased respiratory rate. The client is complaining of headache, tingling, palpitations, and is having a difficult time focusing. The nurse would suspect which acid base disorder? Metabolic alkalosis Respiratory alkalosis Metabolic acidosis Respiratory acidosis

Respiratory alkalosis

Which of the following is true about the diagnosis of Alzheimer's disease? A mini-mental status exam (MMSE) score below 15 is diagnostic of Alzheimer's Reversible causes of dementia must be ruled out first An MRI can confirm the diagnosis Genetic testing confirms the diagnosis

Reversible causes of dementia must be ruled out first

In reviewing changes in the older adult, the nurse recognizes that which of the following statements related to cognitive functioning in the older client is true? Reversible physiological disorders (i.e. infection, electrolyte imbalances) are often implicated as a cause of delirium. Delirium is usually easily distinguished from irreversible dementia. Therapeutic drug intoxication is a common cause of dementia. Some level of cognitive deterioration is an inevitable outcome of the human aging process.

Reversible physiological disorders (i.e. infection, electrolyte imbalances) are often implicated as a cause of delirium.

The nurse determines thought the goals of dietary teaching has been met when the patient with celiac disease selects from the menu Scrambled eggs and sausage Buckwheat pancakes with syrup Oatmeal, skim milk, and orange juice Yogurt, strawberries, and rye toast with butter

Scrambled eggs and sausage

A patient is diagnosed with severe hyponatremia. The nurse realizes this patient will mostly likely need which precautions implemented? Hypertensive precautions Infection precautions Neutropenic precautions Seizure precautions

Seizure precautions

A patient with Alzheimer's disease is started on donepezil (Aricept®). Which of the following is a realistic expectation for this therapy? Slowing of disease progression Reversal of the patient's symptoms Prevention of significant cognitive impairment Elimination of plaques and tangles in the brain

Slowing of disease progression

The nurse is instructing a patient diagnosed with AIDS regarding food choices that will increase caloric intake. Which meal choice would indicate that the patient understands the dietary instruction? Baked chicken (thigh), cabbage, small green salad, slice of white bread, dried prunes, and a soda Spaghetti and meat sauce, raisin salad, whole-grain roll with butter, vanilla milkshake (with Ensure), and a piece of pecan pie Vegetable soup, small piece of cornbread, banana pudding, and water Red beans and rice, slaw, tomato, crackers, chocolate pudding, and iced tea

Spaghetti and meat sauce, raisin salad, whole-grain roll with butter, vanilla milkshake (with Ensure), and a piece of pecan pie

The client returns to the nursing unit post-operatively after a colostomy. Which of the following assessments would require immediate action by the nurse? Stoma is draining serous fluid Stoma is bright red Stoma is bluish Stoma is draining no fluid

Stoma is bluish

A patient receiving parenteral fluid therapy complains of the arm "feeling cold" and says that the dressing "feels tight." The nurse suspects the intravenous infusion has infiltrated. What should the nurse do? Change the dressing and observe the site for additional swelling Stop the infusion and remove the catheter Turn off the infusion, reposition the catheter Check for a blood return in the catheter

Stop the infusion and remove the catheter

Fifteen minutes after a blood transfusion is started, a client develops tachycardia, chills and fever. The nurse's best action is to: Slow the blood flow to keep the vein open Stop the transfusion immediately Lightly cover the patient Administer oxygen at high flow rate

Stop the transfusion immediately

An HIV-positive patient is not adhering to the prescribed medication therapy. Which action by the nurse would be most effective at improving patient compliance and the long-term treatment of the disease process? Warn the patient that if the treatment plan is not followed, reimbursement for services is not assured. Talk with the patient about not adhering to the medication schedule. Confront the patient about the noncompliant behavior. Remind the patient that not following the recommended regimen may result in earlier death.

Talk with the patient about not adhering to the medication schedule.

When a patient asks their nurse about why they keep having their CD4 count done, what is the nurse's best response? The CD4 count is just something the doctor uses to look at for a study he is doing. The CD4 count helps to track how HIV is progressing and if the medications are effective, this way, we know how to best treat you. The CD4 count tells us how fast HIV is going to cause your death. The CD4 count isn't important, because you look good and feel good, so don't worry about the numbers.

The CD4 count helps to track how HIV is progressing and if the medications are effective, this way, we know how to best treat you.

A client is admitted to the medical surgical unit for osteoarthritis and weakness in the left lower extremity. The health care provider ordered a cane and physical therapy for the client. The client asks about using the cane. What is the best response by the nurse? The cane should be used on the unaffected side. Make sure the attached tennis balls are secure. The cane should be used on the affected side. You should try to ambulate without the cane as much as possible to improve your gait.

The cane should be used on the unaffected side.

The nurse is caring for clients on a medical floor. Which client should be assessed first? The client diagnosed with gout complaining of flank pain The client diagnosed with SLE who is complaining of chest pain The client diagnosed with MS who is complaining of pain at a "10" The client diagnosed with myasthenia gravis who has dysphagia

The client diagnosed with SLE who is complaining of chest pain

The nurse is assessing a client diagnosed with Rheumatoid Arthritis (RA). Which assessment findings warrant immediate intervention? The client requires a heading pad applied to the hips and back to sleep The client is crying, has a flat facial affect, and refuses to speak to the nurse The client has experienced one kg weight loss and is very tired The client complains of joint stiffness and the knees feel warm to the touch

The client is crying, has a flat facial affect, and refuses to speak to the nurse

Which of the assessment data obtained by the nurse when caring for a patient with thrombocytopenia should be immediately communicated to the physician? The patient is difficult to arouse Areas of ecchymosis on arms Platelet count 102,000/ml Bullae on the oral mucosa

The patient is difficult to arouse

A newly admitted patient has a fasting serum blood glucose level of 125 mg/dL. How should the nurse interpret this value? The patient has type 1 diabetes. This is a critical value that should be reported immediately. The patient may be prediabetic. The patient has normal glucose metabolism.

The patient may be prediabetic.

Mr. Glick is a 52 year old male with Type 2 Diabetes. Mr. Glick wants to start exercising more because his HgbA1C is 7.2%. The nurse knows that it is important to tell the patient which of the following? The patient must use good fitting shoes during his workout Make sure the patient knows the symptoms of hyperglycemia, which can be induced from exercise If the patient starts sweating, he must stop immediately because he could be hypoglycemic The patient should only be checking his glucose after he exercises

The patient must use good fitting shoes during his workout

The nurse is assessing a patient who has a family history of type 2 diabetes. Which finding would require follow-up by the nurse? The patient reports having a new prescription for prednisone for asthma exacerbation. The patient delivered a baby that weighed 8 pounds and 10 ounces. Measurements indicate the patient has decreased the waist-to-hip ratio through dietary changes. The patient's fasting blood glucose level is 95 mg/dL.

The patient reports having a new prescription for prednisone for asthma exacerbation.

The nurse is planning care for a patient who has just had a permanent tracheostomy following total laryngectomy. What should the nurse consider when planning this care? Select all that apply The patient will be unable to speak normally The patient will require enteral feedings until healed The family will be unable to communicate with the patient Writing will be an important form of communication immediately postoperatively The patient will require isolation until the site is healed

The patient will be unable to speak normally The patient will require enteral feedings until healed Writing will be an important form of communication immediately postoperatively

A nursing student is observing is the radiation oncology center today. The preceptor asks what are the basic principles for minimizing radiation exposure. The students response includes: Time, Duration, and Shielding Energy, Time, and Distance, Exposure, Magnitude, and Duration Time, Distance, and Shielding

Time, Distance, and Shielding

A patient who has sickle cell disease asks the nurse why he is in so much pain during a crisis. The nurse explains that the pain of sickling is caused by Infectious processes in organs affected by sickling Tissue ischemia caused by small blood vessel occlusion Spasms of the blood cells as they change shape Deposition of sickled red cells in the bone marrow

Tissue ischemia caused by small blood vessel occlusion

An important component of teaching a patient with sleep apnea is To elevate the head of the bed to 90o To avoid the use of nighttime sedatives To eat a large meal before bedtime To use the BiPAP only when he snores

To avoid the use of nighttime sedatives

The nurse knows that the TNM classification system is used to describe the extent of the tumor and evidence of metastasis through the body. What does TNM mean? Type, Neoplasm, Metastasis Tumor, Nodes, Metastasis Tissue, Nodes, Metastasis Tumor, Nodes, Margins

Tumor, Nodes, Metastasis

Which of the following nursing interventions is most appropriate when communicating with a patient suffering from aphasia post stroke? Present several thoughts at once so that the patient can connect the ideas. Use simple, short sentences accompanied by visual cues to enhance comprehension. Finish the patient's sentences so as to minimize frustration associated with slow speech. Ask open-ended questions to provide the patient the opportunity to relearn speech.

Use simple, short sentences accompanied by visual cues to enhance comprehension.

A patient is experiencing manifestations consistent with an oral fungal infection. The patient's health history is unremarkable. Which medication(s) does the nurse anticipate being ordered to manage this condition initially? (select all that apply) Viscous lidocaine Nystatin Ciprofloxacin listerene mouthwash Ampicillin

Viscous lidocaine Nystatin

A client is to receive a unit of packed red blood cells (PRBCs). The nurse and another nurse have confirmed that the correct blood for the client has been obtained from the blood bank. Immediately prior to starting the blood transfusion, what client assessment should the nurse take? Creatinine clearance Skin color Vital signs Hemoglobin level

Vital signs

The nurse is caring for a client with acquired immunodeficiency syndrome (AIDS). Which activity by the nurse should be reported to the employee health department as an exposure for the nurse? The nurse does not wear a mask while in the client's room While flushing out the used bedpan, fluid splashes in the nurse's eyes The nurse is stabbed with a sterile syringe to be used to draw up the client's medications During the bath, the nurse removes gloves when giving a backrub on intact skin

While flushing out the used bedpan, fluid splashes in the nurse's eyes

When counseling a patient about breast cancer prevention, the nurse considers that the patient has a significant family history of breast cancer if she has? a paternal grandmother who died from breast cancer at the age of 72. a cousin who was diagnosed with breast cancer at the age of 60 and ovarian cancer at the age of 68. a mother and maternal aunt who were diagnosed with breast cancer at the ages of 42 and 45, respectively. a sister who died from ovarian cancer at the age of 29.

a mother and maternal aunt who were diagnosed with breast cancer at the ages of 42 and 45, respectively.

When obtaining a nursing history from a patient with benign prostatic hyperplasia (BPH), the nurse would expect the patient to report grossly bloody urine. lower back pain that radiates to the hips during urination. a weak urinary stream and dribbling at the end of urination. difficulty maintaining an erection.

a weak urinary stream and dribbling at the end of urination.

A patient who had a Mantoux test for tuberculosis 2 days ago has a 2 mm area of erythema at the site of the test. How should the nurse evaluate this result? As indicating need for a repeat PPD As negative As positive for tuberculosis As indicating a sputum test for acid-fast bacilli is needed

as negative

When administering sliding scale insulin, the nurse knows to check which of the below before administering? Select all that apply. Shake the vial to mix it good before administering How many calories the patient plans on eating Correct type of insulin Recent blood glucose level When the patient plans on eating Drug order and calculation

correct type of insulin recent BG level when the pt plans on eating drug order and calculation

A client is brought to the emergency department with a suspected narcotic (heroin) overdose. The nurse anticipates that assessment findings and ABGs will reveal: restlessness and hypoxemia agitation and alkalosis decreased level of consciousness and acidosis tachypnea and acidosis

decreased level of consciousness and acidosis

The nurse knows that the lungs act as an acid base buffer by decreasing the respiratory rate and depth when CO2 levels in the blood are low, increasing acid load. decreasing respiratory rate and depth when CO2 levels in the blood are high, reducing the acid load increasing respiratory rate and depth when CO2 levels in the blood are high, reducing acid load. increasing respiratory rate and depth when CO2 levels in the blood are low, reducing base load

increasing respiratory rate and depth when CO2 levels in the blood are high, reducing acid load.

The U.S cancer prevention task force includes recommendations to reduce cancer cases by preventative screening such as (select all that apply). mammograms HPV screening/ PAP smears smoking cessation chest xray fecal occult blood test

mammograms HPV screening/ PAP smears fecal occult blood test

What are common precipitating factors of hypoglycemia? Select all that apply. Hemodialysis Missing meals or snacks Excessive insulin Wrong type of insulin

missing meals or snacks excessive insulin wrong type of insulin

A patient returns to the surgical unit following a right modified radical mastectomy with dissection of axillary lymph nodes. Postoperative orders include diet as tolerated, up ad lib, J-vac drains, and PCA at 1 mg morphine every 10 minutes. What is the best intervention for the nurse to include in implementing postoperative care for the patient? posting a sign at the bedside warning against blood pressures or venipunctures in the right arm teaching the patient to use the PCA every 10 minutes for the best pain relief encouraging the patient to obtain a permanent breast prosthesis as soon as she is discharged from the hospital insisting that the patient examine the surgical incision when the dressings are removed

posting a sign at the bedside warning against blood pressures or venipunctures in the right arm

The nurse is reviewing literature to present to a group of students on the risk of acquiring HIV. The nurse understands that which populations are most at risk? Select all that apply Clients with nephropathy Prison population Bisexual males Gay men IV drug abusers

prison population bisexual men gay men iv drug abusers

The nurse is planning care for a patient with fluid volume overload and hyponatremia. Which intervention should be included in this patient's plan of care? Administer Intravenous fluids Restrict fluids Provide Kayexalate (sodium polystyrene sulfonate) Administer intravenous Normal Saline with Furosemide (Lasix)

restrict fluids

The nurse is providing teaching to a patient who will be beginning chemotherapy treatments, the nurse explains that nausea and vomiting is a common side effect of chemotherapy. The nurse includes the following teaching for the patient beginning chemotherapy: (select all that apply) provide parenteral nutrition sip flat ginger ale, weak ginger, or mint tea eat small meals to avoid an empty stomach take prescribed antiemetic medications before treatment begins limit fluids during meals and eat calorie dense foods first

sip flat ginger ale, weak ginger, or mint tea eat small meals to avoid an empty stomach take prescribed antiemetic medications before treatment begins

The nurse is teaching the client about risk factors for osteoporosis. It is most important for the nurse to include which factors? Select all that apply. Smoking Family history Oral hypoglycemics Long term corticosteroid therapy Morbid obesity Blood pressure medications Inadequate dietary intake of calcium

smoking family history long term corticoid steriod use inadequate dietary intake of calcium

The nurse assesses a patient with a diagnosis of osteoarthritis. The nurse expects to see which signs and symptoms? stiffness of the knees, hips, vertebrate, and fingers. pain on abduction of the hips and a waddling gait Swan neck deformity of the hands fever, rash, and red swollen joints

stiffness of the knees, hips, vertebrate, and fingers.

A patient with a tracheostomy has a continuous pulse ox monitor. The SpO2 drops from 95-89%. Identify appropriate nursing actions for this patient. (Select all that apply). Suction the tracheostomy Give the prescribed bronchodilator Assess breath sounds Initiate mechanical ventilation Check the oxygen flow rate and connections

suction the tracheostomy give the prescribed bronchodilator assess breath sounds check oxygen flow rates and connections

A 72-year-old woman hospitalized with pneumonia becomes disoriented and confused 2 days after admission. When assessing the patient's status, the nurse determines that the patient is experiencing delirium rather than dementia, based on the knowledge that awareness is clear in delirium but impaired in dementia. the onset of delirium is acute, while that of dementia is usually insidious. memory is impaired in delirium but not in dementia. dementia usually has an identifiable cause, while delirium does not.

the onset of delirium is acute, while that of dementia is usually insidious.

The nurse is teaching young adults about behaviors that put them at risk for oral cancer includes: excessive use of chewing gum drinking carbonated beverages use of perfumed lip gloss use of smokeless tobacco

use of smokeless tobacco