Quiz Questions

Magnesium (Mg2+) normal range

1.8-2.6 mEq/L

Sodium (Na+) normal range

135-145 mEq/L

ROME method

Reading in this order - pH, pCO2, HCO3 Respiratory is Opposite Metabolic is Equal If pH is opposite to the CO2 (high v. low) it is respiratory If pH is equal to HCO3 (both high, both low) it is metabolic

HCO3 normal range

22-26 mEq/L *metabolic

Potassium (K+) normal range

3.5-5.0 mEq/L

PaCO2 normal range

35-45 mm Hg *respiratory *opposite directions for acid/base

pH normal range

7.35-7.45

Calcium (Ca+) normal range

9.0-10.5 mg/dL

Chloride (Cl-) normal range

96-106 mEq/L

A nurse teaches a patient who is being discharged home with a peripherally inserted central catheter (PICC). Which statement will the nurse include in this patient's teaching? a. "avoid carrying your grandchildren with the arm that has the central catheter" b. "be sure the place the arm with the central catheter in a sling during the day" c. "you can use the arm with the central catheter for most ADL's" d. "flush the PICC line with normal saline daily"

a. "avoid carrying your grandchildren with the arm that has the central catheter"

A patient is prescribed 1000 mL of normal saline to infuse over 24 hours. At what rate will the nurse set up the pump (mL/hr) to deliver this infusion? (round to whole number in mL/hr) a. 42 mL/hr b. 44 mL/hr c. 40 mL/hr d. 60 mL/hr

a. 42 mL/hr

A provider orders dantrolene 2 mg, IV, one dose STAT. The pharmacy provides dantrolene in a vial containing 0.333 mg/mL after reconstitution. Calculate the volume (mL) per dose to be administered of these parenteral medications. Round to the nearest tenth mL. a. 6 mL b. 6.01 mL c. 6.4 mL d. 5.9 mL

a. 6 mL

The nurse utilizing evidence-based practice (EBP) considers which factors when planning care? SATA a. Cost-saving measures b. Nurse's expertise c. Client preferences d. Research findings e. Values of the client

a. Cost-saving measures b. Nurse's expertise d. Research findings e. Values of the client

A nurse is assessing patient's on a med-surg unit. Which adult patient does the nurse identify as being at greatest risk for insensible water loss? a. anxious patient who has tachypnea b. patient taking furosemide c. patient who is constipated with abdominal pain d. patient who is on fluid restrictions

a. anxious patient who has tachypnea

A nurse responds to an IV pump alarm related to increased pressure. What action will the nurse take first? a. assess the infusion system starting at the insertion site b. silence the alarm and restart the infusion on a new infusion pump c. flush the catheter with saline followed by a thrombolytic enzyme d. remove the IV catheter and insert a new IV at a new site

a. assess the infusion system starting at the insertion site

After teaching a patient who is prescribed a restricted sodium diet, a nurse assesses the patient's understanding. Which food choice for lung indicates that the patient correctly understood the teaching? a. grilled chicken breast with glazed carrots b. slices of smoked ham with potato salad c. bowl of tomato soup with a grilled cheese sandwich d. salami and cheese on whole-wheat crackers

a. grilled chicken breast with glazed carrots

An older patient had hip replacement surgery and the surgeon prescribed morphine sulfate for pain. The patient is allergic to morphine and reports pain and muscle spasms. When the nurse calls the surgeon, which medication should he or she suggest in place of morphine? a. hydromorphone hydrochloride (Dilaudid) b. meperidine (Demerol) c. cyclobenzarine (Flexeril) d. ketorolac (Toradol)

a. hydromorphone hydrochloride (Dilaudid)

A nurse assesses a patient who is admitted for treatment of fluid overload. Which manifestations does the nurse expect to find? SATA a. increased pulse rate b. decreased BP c. warm and pink skin d. skeletal muscle weakness e. distended neck veins

a. increased pulse rate d. skeletal muscle weakness e. distended neck veins

A nursing student working in an Acute Care of the Elderly unit learns that frailty in the older population includes which components? SATA a. slowed physical activity b. dementia c. exhaustion d. weakness e. weight gain

a. slowed physical activity c. exhaustion d. weakness

A nurse is assesing patient's who have IV therapy prescribed. Which assessment finding for a patient with a peripherally inserted central catheter (PICC) requires immediate attention? a. upper extremity swelling is noted b. the initial site dressing is 3 days old c. the PICC was inserted 4 weeks ago d. a securement device is absent

a. upper extremity swelling is noted

A newly graduated nurse in the hospital states that, since she is so new, she cannot participate in quality improvement (QI) projects. What response by the precepting nurse is best? a. "it's easy to identify what indicators should be used to measure quality" b. "even being new, you can implement activities designed to improve care" c. "all staff nurses are required to participate in quality improvement here" d. "you should ask to be assigned to the research and quality committee"

b. "even being new, you can implement activities designed to improve care"

A nurse teaches a patient who is at risk for mild hypernatremia. Which statement does the nurse include in this patient's teaching? a. "bake or grill the meat rather than frying it" b. "read food labels to determine sodium content" c. "check your radial pulse twice a day" d. "weigh yourself every morning and every night"

b. "read food labels to determine sodium content"

A nurse is calling the on-call physician about a patient who had a hysterectomy 2 days ago by Dr. Smith and has pain that is unrelieved by the prescribed opioid pain medication. Which statement does comprise background portions of the SBAR format for communication? a. "Dr. Smith doesn't like non-steroidal anti-inflammatory meds" b. "this patient has allergies to morphine and codeine" c. "this patient had a vaginal hysterectomy 2 days ago" d. "I am wondering if we could try a different pain medication"

b. "this patient has allergies to morphine and codeine"

A provider orders oxacillin, 25 mg/kg/day, IV, every 8 hours for a child who weighs 4 kg. What volume (mL) of reconstituted oxacillin should be administered per dose? Round to the nearest tenth mL a. 1.2 mL b. 1.3 mL c. 1.4 mL d. 1.5 mL

b. 1.3 mL

A nurse prepares to administer a blood transfusion to a patient, and checks the blood label with a second RN using the International Society of Blood Transfusion (ISBT) universal bar-coding system to ensure the right blood for the right patient. Which components must be present on the blood label in bar code and in eye-readable format? SATA a. name of the patient receiving blood b. ABO group and Rh type of the donor c. unique facility identifier d. blood type of the patient receiving blood e. lot number related to the donor

b. ABO group and Rh type of the donor c. unique facility identifier e. lot number related to the donor

A nurse caring for an older patient in the hospital is concerned the patient is not competent to give consent for upcoming surgery. What action by the nurse is best? a. have the patient's family sign the consent b. discuss concerns with the healthcare team c. call Adult Protective Services d. do not allow the patient to sign the consent

b. discuss concerns with the healthcare team

A nurse is caring for a postoperative patient on the surgical unit. The patient's BP was 142/76 mmHg 30 minutes ago, and now is 88/50 mmHg. What action by the nurse is best? a. Repeat BP measurement in 15 minutes b. call the Rapid Response Team c. notify the primary care provider d. document and continue to monitor

b. call the Rapid Response Team

A nurse assesses a patient who was started on intraperitoneal therapy 5 days ago. The patient reports abdominall pain and "feeling warm". For which complication of this thearpy will the nurse assess this patient? a. bowel obstruction b. infection c. catheter lumen occlusion d. allergic reaction

b. infection

A nurse cares for a patient who has serum potassium of 7.5 mEq/L (7.5 mmol/L) and is exhibiting cardiovascular changes. Which prescription will the nurse implement first? a. provide a heart-healthy, low-potassium diet b. prepare to administer dextrose 20% and 10 units of regular insulin IV push c. prepare to administer sodium polystyrene sulfate (Kayexalate) 15 g by mouth d. prepare the patient for hemodialysis treatment

b. prepare to administer dextrose 20% and 10 units of regular insulin IV push

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. two scrambled eggs, a slice of white toast, half cup (120g) of strawberries b. sausage, once slice of whole-wheat toast, half cup of raisins (120g), and a glass of milk c. bowl of oatmeal with brown sugar, a half cup of sliced peaches (120g), and coffee d. toasted english muffin with butter and blueberry jam, and tea with sugar

b. sausage, once slice of whole-wheat toast, half cup of raisins (120g), and a glass of milk

After teaching a patient who is being treated for dehydration, a nurse assesses the patient's understanding. Which statements indicates that the patient correctly understood the teaching? a. "I must drink a quart (liter) of water or other liquid each day" b. "I will use a salt substitute when making and eating my meals" c. "I will weigh myself each morning before I eat or drink" d. "I will not drink liquids after 6pm so I won't have to get up at night"

c. "I will weigh myself each morning before I eat or drink"

A nurse is working with an older patient admitted with mild dehydration. What teaching does the nurse provide to best address this issue? a. "take your diuretic in the morning" b. "dehydration can cause incontinence" c. "have something to drink every 1-2 hours" d. "cut some sodium out of your diet"

c. "have something to drink every 1-2 hours"

A provider orders enalapril 7.5 mg, PO, once daily. Te pharmacy provides enalapril in tablets containing 5 mg. Calculate the number of tablets to be administered per dose for these oral medications in solid forms. Round to the nearest 1/2 tablet. a. 0.5 tablets b. 1 tablet c. 1.5 tablets d. 2 tablets

c. 1.5 tablets

A patient is prescribed 250 mL of normal saline to infuse over 4 hours via gravity. The facility supplies gravity tubing with a drip factor of 15 drops/mL. At what rate (drops/min) will the nurse set the infusion to deliver? (round to whole number in drops/min) a. 14 drops/min b. 15 drops/min c. 16 drops/min d. 17 drops/min

c. 16 drops/min

A provider orders furosemide 40 mg, IV, daily in the morning. The pharmacy provides furosemide in vials containing 40 mg in 4 mL. Calculate the volume (mL) per dose to be administered to these parenteral medications. Round to the nearest tenth mL a. 2 mL b. 3 mL c. 4 mL d. 5 mL

c. 4 mL

A patient is going to be admitted for a scheduled surgical procedure. Which action does the nurse explain is the most important thing the patient can do to protect against error? a. keep the doctor's phone number by the telephone b. write down the name of each caregiver who comes in the room c. bring a list of all medications and what they are for d. make sure that all providers wash hands before entering the room

c. bring a list of all medications and what they are for

A nurse is caring for a patient who has just had a central venous access line inserted. What action will the nurse take next? a. begin the prescribed infusion via the new access b. make sure that the solution is appropriate for a central line c. ensure that an x-ray is completed to confirm placement d. check medication calculations with a second RN

c. ensure that an x-ray is completed to confirm placement

A med-surg nurse is concerned about the incidence of complications related to IV therapy, including bloodstream infection. Which intervention will the nurse suggest to the management team to make the biggest impact on decreasing complications? a. require additional education for all nurses b. perform quality control testing on skin preparation products c. initiate a dedicated team to insert access devices d. limit the use of peripheral venous access devices

c. initiate a dedicated team to insert access devices

A home healthcare nurse has conducted a home safety assessment for an older adult. There are five concrete steps leading out from the front door. Which intervention would be most helpful in keeping the older adult safe on the steps. a. instruct the patient to use the garage door instead b. tell the patient to use a two-footed gait on the steps c. install contrasting color strips at the edge of each step d. have the patient use a walker or cane on the steps

c. install contrasting color strips at the edge of each step

A hosptialized older adult has been assessed at high risk for skin breakdown. Which actions does the registered nurse (RN) delegate to the UAP? SATA a. assess skin redness when turning b. document Braden Scale numbers c. obtain a pressure-relieving mattress d. keep the patient's skin dry e. turn the patient every 2 hours

c. obtain a pressure-relieving mattress d. keep the patient's skin dry e. turn the patient every 2 hours

A nurse is assessing coping in older women in a support group for recent widows. Which statement by a participant best indicates potential for successful coping? a. "I think I am coping okay all by myself" b. "Oh, I have lots of friends at the senior center" c. "my kids come to see me every weekend" d. "I have had the same best friend for decades"

d. "I have had the same best friend for decades"

A nurse is caring for patients with electrolyte imbalances on a med-surg unit. Which clinical manifestations are correctly paired with the contributing electrolyte imbalances? SATA a. Hypercalcemia - positive Trousseau's and Chvostek's signs b. Hypomagnesemia - bradycardia, peripheral vasodilation, and hypotension c. Hyperphosphatemia - paresthesia with sensations of tingling and numbness d. Hyponatremia - decreased level of consciousness e. Hypokalemia - flaccid paralysis with respiratory depression

d. Hyponatremia - decreased level of consciousness e. Hypokalemia - flaccid paralysis with respiratory depression

A nurse is caring for an older adult patient who is admitted with moderate dehydration. Which intervention will the nurse implement to prevent injury while in the hospital? a. ask family members to speak quietly to keep the patient calm b. encourage the patient to drink at least 1 L of fluids each shift c. assess urine color, amount, and specific gravity each day d. dangle the patient on the bedside before ambulating

d. dangle the patient on the bedside before ambulating

A nurse caring for an older patient on a medical-surgical unit notices that the patient reports frequent constipation and only wants to eat softer foods such as rice, bread, and puddings. What assessment should the nurse perform first? a. weigh the patient b. check skin turgor c. auscultate bowel sounds d. perform an oral assessment

d. perform an oral assessment