PNC: Prep-U

Cerebral edema peaks at which time point after intracranial surgery?

24 hours

An initial bolus of crystalloid fluid replacement for a child in shock is 20 ml/kg. The nurse is preparing to administer how many milliliters of fluid for a child weighing 30 kg?

600mL

Who is considered to be the first nursing theorist who conceptualized nursing in terms of manipulating the environment?

Florence Nightingale

A nurse is working within the managed care delivery model. Which is true regarding managed care?

all systems reflect values of efficiency and effectiveness

The nurse is caring for a primagravida in active labor. The provider performs an amniotomy to augment labor. What is the nurse's priority action after the procedure is completed?

check fhr for bradycardia

A group of objects with relationships is which?

concept

The nurse evaluating a client's blood work notes that the client's white blood cells are 9000/μL (9.0 x 109/L). The nurse should:

continue to monitor blood work results

During the insertion of a rigid scope for bronchoscopy, a client experiences a vasovagal response. The nurse should expect

drop in HR

One of the primary advantages of the managed care model is:

economic, quality care

Nurses have an important role in healthcare reform. The goals of healthcare reform include which of the following?

focus on cost containment with improved access and quality of services for everyone

Home health care nurses are required to complete the Outcome and Assessment Information Set (OASIS) by which entity?

medicare

A group of nursing students is reviewing information about palliative care. The students demonstrate a need for additional review when they identify which of the following?

palliative care is the same as hospice care

A client is diagnosed with oppositional defiant disorder (ODD). Which assessment finding would indicate that the client needs medications?

presence of comorbid psychiatric disorders

A nurse is volunteering time at a homeless shelter in an urban setting. What service provided by the nurse would be of benefit to this population of clients?

providing education program about nutrition

The nurse is caring for a client who requests to see a copy of the client's own health care records. What action by the nurse is most appropriate?

review hospital process for allowing client to view

Which statement by the nurse shows an understanding of the focus of the quality assurance programs developed in the 1980s?

the quality assurance programs focus on processes used to provide care and improving those processes

Which is not a purpose of the client care record?

to serve as a contract with the client

The mother of a newborn infant questions why her baby needs a vitamin K injection immediately after birth. The best response by the nurse would be:

infants are not born with the normal intestinal bacteria that synthesize vitamin K for clotting

A client with a history of schizophrenia has been receiving antipsychotic therapy for several years. Which would indicate to the nurse that the client is experiencing pseudoparkinsonism?

cogwheel rigidity

Everyone in the family except the mother currently has influenza. What should the nurse tell the mother are appropriate measures to avoid this infection? Select all that apply.

-immunization -frequent hand washing -avoid close contact w/family

What statements best describe giving birth to a child in 1700s America? Select all that apply.

-men did not attend -female midwives attended births at home -women faced birth with fear of death

The nurse caring for clients at an outpatient clinic determines that which client is at greatest risk for infection?

80y/o woman

Which is usually the most important consideration in the decision to initiate antiretroviral therapy?

CD4+ count

Which of the following disorders results in widespread hemorrhage and microthrombosis with ischemia?

DIC

A client has just been transferred to the postanesthesia recovery room following a laparotomy. In addition to vital signs, what are the most important initial assessments that need to be completed?

LOC, pain, wound dressing

The nurse is caring for a client with endocarditis who will require 6 weeks of antibiotic therapy. The nurse should anticipate which type of access for this client?

PICC in R axillary vein

Which represents the best definition of a theory?

a person's or group's beliefs about how something happens or works

When providing care to a newborn with necrotizing enterocolitis (NEC), the nurse would need to report which finding immediately?

abdomen appearing red & shiny

Which nursing intervention is most likely to be allowed within the parameters of a protocol or standing order?

admin glycerin suppository to constipated client w/o response to oral stool softeners

The nurse is caring for a child whose family recently emigrated from a developing country. While completing the admission history, the parents report all the child's immunizations are up to date. Which nursing action is most appropriate?

ask parents which immunizations have been given

Which program provides comprehensive, highly individualized consumer services to those with severe and persistent mental illness?

assertive community treatment

During the first 24 hours after a client is diagnosed with addisonian crisis, which intervention should the nurse perform frequently?

assess VS

A client in the emergency department states, "I have always taken a morning walk, but lately my leg cramps and hurts after just a few minutes of walking. The pain goes away after I stop walking, though." Based on this statement, which priority assessment should the nurse complete?

attempt to palpate the dorsalis pedis and posterior tibial pulses.

The nurse is caring for a client with an elevated blood pressure and no previous history of hypertension. At 0900, the blood pressure was 158/90 mm Hg. At 0930, the blood pressure is 142/82 mm Hg. The nurse is most correct when relating the fall in blood pressure to which structure?

baroreceptors

What would be considered a peripheral anticholinergic effect of anticholinergic drug therapy?

blurred vision

A client is admitted to an acute care facility after having a stroke. The client will require a variety of healthcare services throughout the hospital stay as well as coordination of care prior to discharge. What referral would be a priority for overseeing the client's care?

case management

A neonate is admitted to the nursery following a long and difficult labor. Admission vital signs are temperature 96.5° F (35.8° C), heart rate 168 beats/minute, and respiratory rate 64 breaths/minute. After placing the neonate under the radiant heater, the nurse should take which action?

check neonates BG

A 33-year-old female client with three children has had a follow-up mammogram after an abnormal BSE. Mammogram findings reveal incidental microscopic abnormal tissue growth in the left breast lobules. The physician orders tamoxifen for the client. The nurse understands that the physician is implementing which primary prevention modality to treat this client?

chemoprevention

The nurse is collaborating closely with the provider of a client whose helminthic infection is being treated with albendazole. What aspect of the client's pre-illness health status creates a heightened risk for adverse effects of albendazole?

client often takes cimetidine 200mg PO to treat dyspepsia

The nurse is preparing to document the nursing diagnoses for a client. What is the most appropriate outcome for the nursing diagnosis of impaired gas exchange?

client will maintain pulse ox reading of greater than 94%

The nurse is conducting a physical examination of a toddler with suspected lead poisoning. Laboratory results indicate a blood lead level of 52 mcg/dl (2.51 µmol/L). For which action will the nurse plan?

confirm with repeat in 2 days, educate parents on how to decrease exposure

Which statement regarding depression and gender is correct?

depressive disorders are more common in women than men

A recent immigrant is diagnosed with pulmonary tuberculosis (TB). Which intervention is the most important for the nurse to implement with this client?

develop list of people came in contact with

A nurse is teaching a client about the pharmacotherapeutics of the hormone replacement therapy that the client has been prescribed. What topic should the nurse address?

effect of drug on client's body

A client comes to the emergency department reporting chest pain. An electrocardiogram (ECG) reveals myocardial ischemia and an anterior-wall myocardial infarction (MI). Which ECG characteristic does the nurse expect to see?

elevated ST segment

A mental health nurse is interviewing a child for suspected abuse. The parent states that the child is having disciplinary problems at school and stutters when approached. From the listed behavioral indicators, the nurse would suspect which type of abuse?

emotional

Which is the primary goal of continuity of care?

ensuring a smooth and safe transition between different health care settings

A nursing instructor is describing to a class the various roles that nurses assume. The instructor determines that teaching has been effective when the students identify which of the following as the focus of the nursing researcher role?

establishment of scientific basis for action

The nurse is planning discharge of the client who had surgery for a left hip replacement. The client is being discharged from the hospital to the home and requires home medical services. Which item would be provided by home medical services?

high-rise toilet seat

A nurse has the Petty Family as a client, who consists of a wife, husband, and their 4-year-old daughter. The husband has been unemployed for 8 months, and they lost their apartment. The family has been staying in neighborhood shelters and, on occasion, with the husband's father for a night or two. When evaluating this family, the nurse identifies this family as which type?

homeless family

The nurse researcher is aware that the type of variable that can be manipulated in a study is which type of variable?

independent

For a hospital to meet criteria regarding nursing care established by The Joint Commission, the nurse must conduct which type of assessment?

initial

Which intervention is the most critical for a client with myxedema coma?

maintaining patent airway

The nurse is providing care to several clients. For which client should the nurse include secondary care in the nursing plan of care?

middle aged client who presents with new onset angina

The goal of the deinstitutionalization movement was to achieve which outcome?

move psychiatric clients out of the hospitals and into the community in an effort to provide a better quality of life for them

A client's diagnosis of pneumonia requires treatment with antibiotics. The corresponding order in the client's chart should be written as

moxifloxacin 400 mg daily

What statement describes a required characteristic of all generic drugs?

must be therapeutically equivalent to brand name

The nurse suspects that a patient with diabetes has developed proliferative retinopathy. The nurse confirms this by the presence of which of the following diagnostic signs?

neovascularization into vitreous humor

An informatics nurse is involved in testing an update to a clinical information system. Numerous caregivers are using the system at the same time. The testing is being done to see if the system can handle the large amount of users at one time. The nurse is involved with which type of testing?

performance

When assessing a patient with risk factors related to human immunodeficiency virus (HIV), what does the nurse know can be the first manifestation of the disease?

purplish cutaneous lesions

When a researcher begins to form plans for a research project, the researcher must decide on the method for conducting the research. The nurse researcher that plans to emphasize collection of narrative data and the analyses would select which of the following methods of research?

qualitative research

A healthcare provider (HCP) calls the hospital unit and requests to leave a new prescription for a client over the phone as the HCP does not have access to the electronic health record (EHR) at present. What action would the nurse take?

receive prescription over the phone & repeat it back to HCP to verify

A conceptual framework is defined as:

set of concepts and propositions

The nurse instructs a client recovering from a myocardial infarction (MI) about cardiac rehabilitation. The client states, "I will not be able to do rehabilitation because I have very bad knees." What is the nurse's best response?

the rehabilitation team will assess you and recommend activities that accommodate for your knee problems

You are caring for a client on tube feedings. The physician has ordered Osmolite HN as the feeding formula for the client. The family asks why the physician has ordered Osmolite HN instead of another formula to feed their family member. What is an important reason that tube-feeding formulas, such as Impact, Osmolite HN, or Peractive, be recommended to clients?

to enhance production of lymphocytes and NK cells

The nurse is admitting a client from the emergency department with a reported spinal cord injury. What device would the nurse expect to be used to provide correct vertebral alignment and to increase the space between the vertebrae in a client with spinal cord injury?

traction with weights & pulleys

What symptoms should the nurse assess for in a client with lymphedema as a result of impaired nutrition to the tissue?

ulcers and infection in edematous area

The nurse is caring for a client who has sickle cell disease (SCD). The client is reporting pain in the back, chest, and extremities. The nurse anticipates that the client may present with what other clinical manifestation(s)? Select all that apply.

-HTN -nausea -tachypnea -swelling

When assessing a client's risk for pressure ulcer development, which finding would alert the nurse to an increased risk? Select all that apply.

-anemia -edema -diaphoresis

It is important that nurses include a discussion about teratogens in their prenatal discussions to help prevent deformities or abnormalities. Which substance(s) would the nurse include as a teratogen(s)? Select all that apply.

-caustic chemicals -certain meds -alcohol

A group of nurses are working to provide quality care for their clients within the current health care environment of cost containment. Which strategy(ies) would be appropriate for the nurses to use? Select all that apply.

-create easy access programs for immunizations -educating client about seeking help for problems early on -urging client to participate in screening programs

An infant is receiving phototherapy using a fiberoptic pad (Biliblanket). What interventions are appropriate to include in the nursing plan of care? Select all that apply.

-encourage parents to participate in infants care -document frequency and character of stools

What are the goals of the research that is behind the Nursing Outcomes Classification (NOC) system? Select all that apply.

-identify, label, validate nursing sensitive client outcomes & indicators -evaluate validity & usefulness of classification in clinical field testing -define & test measurement procedures for outcomes & indicators

A nurse is reviewing the laboratory test results of a 3-year-old child. Which absolute neutrophil count would the nurse identify as indicating neutropenia?

1.0

The nurse receives an order to administer leuprolide 50 mcg/kg subcutaneously to a child with precocious puberty. The child weighs 66 lbs (30 kg). What is the correct dosage in milligrams? Round to a single decimal place.

1.5

A client is admitted to the emergency department after a motorcycle accident. Upon assessment, the client's vital signs reveal blood pressure of 80/60 mm Hg and heart rate of 145 beats per minute. The client's skin is cool and clammy. Which medical order for this client will the nurse complete first?

100% o2 via nonrebreather mask

Which statement accurately reflects the findings of the 1999 Institute of Medicine report, "To Err Is Human"?

Anywhere from 44,000 to 98,000 people are estimated to die in U.S. hospitals each year as a result of preventable medical errors

A nurse is developing a set of programs that focuses on reducing the risk factors for mental health problems for a community health care center. Which program would be least appropriate?

genetic counseling

A client comes to the clinic and reports being ill for several weeks but does not have insurance and has delayed care. What does the nurse understand about the overall healthcare reform goals that will address issues such as this client?

goal of healthcare reform is to provide affordable healthcare to more individuals

Which documentation tool will the nurse use to record the client's vital signs every 4 hours?

graphic sheet

Prior to initiating hemodialysis therapy on a client, the nurse notes that the client's heart rate is 50 beats/min, blood pressure is 110/78 mm Hg, and respirations are 14 breaths/min. What is the best action by the nurse?

notify hcp

A nurse-manager recognizes that infiltration commonly occurs during I.V. infusions for infants on the hospital's inpatient unit. The nurse-manager should

obtain data about infiltrations to study common threads

The nurse is providing care to several clients on a medical-surgical unit. For which client's plan of care should the nurse include information regarding extended care?

older adult client who fell at home & required hip replacement

A client asks an RN to prescribe a medication for pain. What is the best answer by the nurse?

only APRN can do this

Which would be the benefit of including a client's family members in the long-term treatment of a client with schizophrenia?

onset of a possible relapse can be detected early & effective treatment can be initiated

Which of the following is the most effective intervention for preventing progression of vascular disease?

risk factor modification

What should the nurse suggest to assist a client to improve his cholesterol levels?

smoking cessation

The nurse is caring for a premature infant who is demonstrating poor weight gain secondary to difficulty with feedings and sucking. What referral would the nurse consider for the infant?

speech therapy

A nurse is working on a labor and delivery unit that requires all visitors to pass a screening protocol prior to entry. What is the nurse's priority action when a person gains access to the unit after bypassing the screening protocol?

stop & ask for ID

Which interventions will the nurse include when caring for a child with an infectious disorder? Select all that apply.

-provide info about disease transmission -educate child & family about infection control -ensure immunizations current -use appropriate PPE

A nurse is performing health promotion activities for clients at a local health care clinic. Which nursing actions exemplify the focus of secondary preventive care? Select all that apply.

-screening for HTN -refer to family counseling -schedule mammogram

A client is to start receiving chemotherapy at 10:00 AM. The client has an order for intravenous metoclopramide. The nurse would expect to give the drug at which time?

0930

As a nurse-manager of a medical-surgical unit reviews the month's risk-management data, she notices that a number of incident reports were completed because 6 p.m.(1800) medications were administered late. Dinner is served between 5:30 p.m. (1730) and 6 p.m. (1800). Staff take their dinner breaks between 5 p.m. (1700) and 6:30 p.m.(1830). Based on this information, which is the most appropriate action for the nurse-manager to take?

Investigate when medications are given, staff and client dinner times, the number of medications that must be given at 6 p.m. (1800), and staff availability between 5 p.m. (1700) and 6 p.m. (1800).

Which is an emerging trend in health care delivery?

active involvement of consumers

Which assessment finding(s) are likely to cause noncompliance with antiretroviral treatment?

active substance abuse

The nurse manager on an orthopedic unit has determined that the nurses are not keeping the nursing diagnoses up-to-date on client care plans and, in turn, are not using the plan of care. What is a feasible approach to correcting this problem?

develop process for periodic review of care plans that focuses on deleting and updating nursing diagnoses

The nurse identifies a potential collaborative problem of electrolyte imbalance for a client with severe acute pancreatitis. Which assessment finding alerts the nurse to an electrolyte imbalance associated with acute pancreatitis?

muscle twitching and finger numbness

What would a nurse expect to be prescribed for a patient experiencing bladder spasms?

oxybutynin

A nurse is planning to participate in a research project and is looking for information about what is already known about the topic. The nurse is involved in which step of the research process?

scientific literature review