Case Study Analysis Practice assessment 2

A nurse is preparing to administer amoxicillin 2 g/day PO divided into two doses. The amount available of amoxicillin 500 mg tablets. How many tablets should the nurse administer with each dose?

2 tablets

A nurse is caring for a client who has a history of alcohol use disorder and reports bruising and frequent nosebleeds. The nurse should recognize that this clients in manifesting which of the following conditions?

A. Malnutrition B. Hepatitis A C. Diabetes D. Cirrhosis

A nurse is teaching a client who has urolithasis (renal calculi). The nurse should explain that which of the following conditions can increase the risk for renal calculi?

A. Protein in the urine B. Dehydration C. Iron Deficiency D. Obesity

A nurse manager is providing an educational program on antibiotic sensitivity to bacterial infections. The nurse should include in the teaching that vancomycin is indicated for which of the following infection?

A. Pseudomonas aeruginosa B. Klebsiella C. Candida D. Methicillin-resistant Staphylococcus aureus

A nurse is calculating the total fluid intake for a client during a 4-hr period. The client consumes 1 cup of coffee, 4 oz of orange juice, 3 oz of water, 1 cup of flavored gelatin, 1 cup of tea, 5 oz of broth and 3 ox of water. The nurse should record how many mL of intake on the client's record?

1170 mL

A nurse is preparing to perform a capillary blood glucose test. Identify the sequence of steps the nurse should follow.

1. Check the expiration date on test strips 2. Perform a quality control test 3. Perform hand hygiene 4. Cleanse puncture site 5. Apply blood sample onto test strip 6. Document results

A nurse is preparing to inset an NG tube for a client who requires gastric suctioning. Place the following steps in the appropriate order.

1. prepare equipment at bedside 2. Measure the NG tube 3. Instruct the client to extend the neck backward 4. Instruct the client to flex his head forward 5. Obtain an x-ray 6. Connect the tube to the suction device

A nurse is preparing to administer clozapine 300 mg PO daily to a client who has schizophrenia. The amount available is clozapine 200 mg tablets. How many tablets should the nurse administer?

1.5 tablets

A nurse is caring for a client who is to receive liquid medication via a gastrostomy tube. The client is prescribed phenytoin 250 mg. The amount available is phenytoin oral solution 25 mg/5 mL. How many mL should the nurse administer per dose?

50 mL

A nurse is teaching a client about the intradermal purified protein derivative (PPD). Which of the following information should the nurse include?

A. "An indurate area of 4 milliliters indicates a positive result" B. "The injection site will be evaluated within 24 hours" C. "This test is performed if previous results are negative" D. "A positive result suggests active infectious disease"

A nurse is discussing the manifestations of alcohol withdrawal with a client who has a history of alcohol use disorder. Which of the following client statements indicates understanding?

A. "I should expect tremors to start less than 24 hours after I stop drinking" B. "Disulfiram will block my cravings for alcohol" C. "My symptoms should last about 5 to 7 days once they begin" D. "It is important that I take vitamin C to prevent cirrhosis or other liver damage"

A nurse is caring for a client who is being treated with a cesium implant. The client tells the nurse, "I feel so isolated and alone in this room." After acknowledging the client's feelings of loneliness, which of the following responses should the nurse provide?

A. "I will come and sit with you for 10 minutes each hour" B. "Do you have a cell phone you can talk to friends and family on?" C. "Ill ask the charge nurse to admit someone to your room for company" D. "You're scheduled for discharged in 2 days so this isolation will be over soon"

A nurse is teaching a female client who has a new prescription for transdermal sumatriptan to treat migraine headaches. which of the following instructions should the nurse include?

A. "Tale the medication daily to prevent headaches" B. "Activate the patch 30 minutes after application" C. "Use contraception while taking this medication" D. "You van bathe with the patch in place"

A nurse is planning home care for a 9-year-old child following an acute exacerbation of asthma. Which of the following of Erikson's developmental stage should the nurse consider in the planning?

A. Autonomy vs. Shane and doubt B. Initiative vs. guilt C. Industry vs. inferiority D. Identity vs. role confusion

A nurse is preparing a teaching plan for a client who has neutropenia as a result of radiation therapy for the treatment of lung cancer. Which of the following should the nurse plan to include in the teaching?

A. Bottled water is an appropriate choice to increase fluid intake B. The salad bar is a healthy choice when dining out C. Soft-boiled eggs are an appropriate source of protein D. Eating at a buffet is a good choice to increase caloric intake

A nurse is caring for a client who develops a ventricular fibrillation rhythm. The client is unresponsive, pulseless, and apnea. which of the following actions is the nurse's priority?

A. Defibrillation B. Airway management C. Epinephrine administration D. Amiodarone administration

A nurse is assessing a client who sustained a basal skull fracture and notes a thin stream of clear drainage coming from the client's right nostril. Which fo the following actions should the nurse take first?

A. Test the drainage for glucose B. Suction the nostril C. Notify the physician D. Ask the client to blow his nose

A community health nurse is reviewing information about infectious diseases with the nurses on her team. The nurse should remind the team that which of the following diseases are included in the list of nationally notifiable infectious diseases? (SATA)

A. Trichomonas vaginalis B. Chlamydia C. Gonorrhea D. Chancroid E. Candidiasis albicans

A nurse is caring for a client who has impaired mobility. Which of the following support devices should the nurse plan to use to prevent the client from developing plantar flexion contractures?

A. Trochanter roll B. Sheepskin heel pad C. Abduction pillow D. Footboard

A nurse is modifying the diet of a client who has Parkinson's disease and is prescribed selegiline, a monoamine oxidase inhibitor (MAOI). Which of the following foods should the nurse eliminate?

A. Fresh fish B. Cheddar Cheese C. Cherries D. Chicken

A nurse is presenting educational materials for a group of middle-aged clients about menopausal hormone therapy following total hysterectomy. Which of the following information should the nurse include in the information?

A. Take at different times of the day B. Take an extra dose if missed a day C. Prevents from having a cerebral hemorrhage D. Prevents osteoporotic fractures

A nurse is administering nasal decongestant drops for a client. Which of the following actions should the nurse take?

A. Tell the client to blow her nose gently before the instillation B. Assist the client to a side-lying position C. Hold the dropper 2 cm (1 in) above the naris D. Instruct the client to stay in the same position for 2 min

A nurse is an ophthalmology clinic is interviewing a client who was referred by his primary care provider for suspicion of cataracts. The nurse should expect the client to report

A. loss of central vision B. having a loss of peripheral vision C. seeing bright flashes of light and floaters D. having a decreased ability to perceive colors

A nurse is caring for a client who reports an area of redness, warmth, tenderness, and pain in the right calf. The nurse anticipates which of the following orders when notifying the provider of this finding?

A. Obtain a venous duplex ultrasound B. Obtain impedance plethysmography C. Monitor Homan's sign D. Apply cold therapy to the affected leg

A nurse is providing dietary teaching to a client who has choleric kidney injury (CKD). The nurse should instruct the client to limit which of the following nutrients? (SATA)

A. Protein B. Calcium C. Calories D. Phosphorus E. Sodium

A nurse in a provider's office is providing teaching to a client about modifiable risk factors for osteoporosis. Which of the following factors should the nurse include? (SATA)

A. Sedentary lifestyle B. Obesity C. Carbonated beverages D. Caffeine intake E. Smoking tobacco products

A nurse is assessing a client who has post traumatic stress disorder (PTSD) following a sexual assault. Which of the following is an expected finding?

A. Sleeping 12 hr or more each day B. Increasing sense of attachment to others C. Constant need to talk about the event D. Increasing feelings of anger

A nurse is teaching a client who is to start taking warfarin about herbal supplements. The nurse should inform he client that which of the following herbal supplements can interact adversely with warfarin?

A. Valerian B. Black cohosh C. Echinacea D. St. John's wort

A nurse is caring for an older adult client who has rheumatoid arthritis and is taking aspirin 650 mg every 4 hours. Which of the following diagnostic tests should the nurse monitor to evaluate the effectiveness of this medication?

A. WBC B. Rheumatoid factor C. Antinuclear antibody D. Erythrocyte sedimentation rate

A nurse reviews the laboratory report for a client who is receiving lithium three times daily PO. The client's current blood lithium level is 1.8 mEq/L. The nurse identifies that this lab value indicates which of the following?

A. A blood lithium level of 1.8 mEq/L is not within the maintenance treatment level B. The lithium level is at the toxic level C. The lithium level is below the therapeutic treatment level D. The lithium level is within the therapeutic level for initial treatment

A nurse is providing teaching about confidentiality with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

A. "The courts might require me to discuss confidential information" B. "I am required to provide confidential information to insurance companies" C. "If questioned during a police investigation, I am required to divulge confidential information" D. "I am legally allowed to discuss confidential information with the client's former therapist"

A nurse is performing an ECG on a client who is experiencing chest pain. Which of the following statement should the nurse make?

A. "You might feel a slight tingling while the test is being done" B. "The test will be complete in 30 to 60 minutes" C. "I will need to apply electrodes to your chest and extremities" D. "The radioactivity from the dye lasts only a few hours"

A nurse is instructing a group of clients regarding calcium rich foods. Which of the following should the nurse include in the teaching as the best source of calcium.

A. 1/2 cup ice cream B. 1 ounce Swiss cheese C. 1 cup milk D. 1 cup cottage cheese

A nurse is caring for a client who is at 40 weeks of gestation and is in labor. The client's ultrasound examination indicates that the fetus is small for gestational age (SGA). Which of the following interventions should be included int he newborn's plan of care?

A. Observe for meconium in respiratory secretions B. Monitor for hypoglycemia C. Identify manifestations of anemia D. Monitor for hyperthermia

A nurse is working on a medical unit is caring for a client who is prescribed seizure precautions. Which of the following interventions should the nurse include in the client's plan of care?

A. Obtain IV access B. Keep the lights on when the client is sleeping C. Place the client's bed in the high position D. Keep a padded tongue blade available at the client's bedside

A nurse is caring for a client who has peripheral vascular disease and reports difficulty sleeping because of cold feet. Which of the following nursing actions should the nurse take to promote the client's comfort?

A. Obtain a pair of slipper socks for the client B. Rub the client's feet briskly for several minutes C. increase the clients oral fluid intake D. Place a moist heating pad under the client's feet

A nurse is teaching a client who needs to increase their daily fluid intake. Which of the following foods has the highest percentage of water by weight?

A. Yogurt B. Milk C. Lettuce D. Honey

A nurse is caring for a client who is receiving a transfusion of packed red blood cells and suspects that the client is experiencing a hemolytic reaction. Which of the following interventions is the priority?

A. Collect a urine specimen B. Administer 0.9% sodium chloride through the IV line C. Stop the transfusion D. Notify the blood bank

A charge nurse is planning a room assignment for a client who has a productive cough, a q questionable chest x-ray, and a positive Mantoux test. Room 208 is private, negative-pressure airflow room; room 212 is semi-private, positive-pressure airflow room; 214 is a negative-pressure, semi-private room; and room 216 is private, positive-pressure airflow room. To which of the following rooms should the nurse assign the client?

A. 208 B. 212 C. 214 D. 216

A nurse participating in lead screenings at a community center. The nurse should instruct parents to bring their children back for prescreening in a year for which of the following laboratory values?

A. 4 mcg/dL B. 10 mcg/dL C. 18 mcg/dL D. 44 mcg/dL

A nurse on a telemetry unit is caring for a client who has unstable angina and is reporting chest pain with a severity of 6 on a 0 to 10 scale. The nurse administers the 1 sublingual nitroglycerin tablet. After 5 min, the client states that his chest pain is now a severity of 2. Which of the following actions should the nurse take?

A. Administer another nitroglycerin tablet B. Initiate a peripheral IV C. Call the Rapid Response Team D. Obtain an ECG

A nurse is caring for an adolescent who has metastatic osteosarcoma. While the parents are away. The adolescent asks the nurse if she is going to die. Which of the following responses should the nurse make?

A. "Your doctor can tell you about your prognosis" B. "You should discuss this with your parents when they return" C. "Tell me more about what you are thinking" D. "You should just focus on getting better"

A nurse in a clinic is assessing a client who has AIDS and a significantly decreased CD4-T cell count. The nurse should recognize that the client is at risk for developing which of the following infectious oral conditions?

A. Halitosis B. Gingivitis C. Xerostomia D. Candidasis

A nurse is preparing medication for a client when another client has an emergency. Which of the following actions should the nurse take?

A. Have another nurse guard the medication preparations until the nurse returns. B. Have another nurse finish preparing the medications C. Lock the medication in a room and finish preparing it after returning from the emergency D. Discard the prepared mediations and begin again after returning

A nurse is preparing for the admission of client who has suspected active tuberculosis. Which of the following precautions should the nurse plan to implement to safely care for this client?

A. Have staff and visitors wear gowns, masks, and gloves while in the client's room B. Place the client in a private room with a special ventilation system C. Assign the client to a room with other clients who require droplet precautions D. Modify the protocol for donning and removing personal protective equipment before entering or leaving the client's room

A nurse is monitoring a client who had a cerebral aneurysm rupture. Which of the following findings should the nurse identify as a manifestation of increased intracranial pressure?

A. Hypotension B. Tachycardia C. Irritability D. Tinnitus

A nurse is planning care for a newborn who has a new diagnosis of phenylketonuria (PKU). Which of the following actions should be included in the plan of care?

A. Initiate a controlled low-protein diet B. Educate parents on blood glucose monitoring C. Administer thyroid hormone replacement D. Obtain a blood sample for blood type

A nurse is caring for a client who has just begun therapy with alprazolam to treat anxiety. The nurse should monitor the client for which of the following adverse effects of this medication?

A. Insomnia B. Bradycardia C. Hearing loss D. Hypertension

A nurse is administering platelets to a client who reports having lower back pain and feeling chilled and itchy. Which of the following actions should the nurse take first?

A. Notify the provider B. Stop the infusion C. Collect a urine sample from the client D. Return the platelet bag and tubing to the blood bank

A nurse is caring for a client who is receiving cisplatin for treatment of ovarian cancer. The client's most recent complete blood count is shown below. It is important for the nurser to consider which of the following for the client. WBC - 1,400 RBC - 4.3 x 10^12 Hgb - 12.1 Hct - 36.5% Platelets - 170,000 Albumin - 4.5

A. the client has an increased risk for bleeding B. the client should receive a diet with increased protein C. the client has an increased risk of infection D. the client should receive an erythropoiesis stimulating agent