course point
Which of the following is the appropriate intervention to avoid physical dependence on drugs in a client?
Discontinue drugs gradually.
Which route of administration of medication is preferred in the most acute care situations?
Intravenous
A physician orders an isotonic I.V. solution for a client. Which solution should the nurse plan to administer?
Lactated Ringer's solution
A client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should the nurse assess first?
Pulse
A nurse evaluates a client's laboratory results. What is a factor that may be affecting an increase in serum osmolality?
free water loss
The nurse is caring for a client recovering from an esophagogastroduodenoscopy (EGD). Which of the following client symptoms would require further nursing assessment?
Abdominal distention
Which could be a potential cause of respiratory acidosis?
Hypoventilation
A client has a respiratory rate of 38 breaths/min. What effect does breathing faster have on arterial pH level?
Increases arterial pH
The health care provider orders the insertion of a single lumen nasogastric tube. When gathering the equipment for the insertion, what will the nurse select?
Levin tube
The nurse is caring for a client with multiple organ failure and in metabolic acidosis. Which pair of organs is responsible for regulatory processes and compensation?
Lungs and kidney
The nurse is caring for a client undergoing alcohol withdrawal. Which serum laboratory value should the nurse monitor most closely?
Magnesium
The nurse cares for a client who receives continuous enteral tube feedings and who is at low risk for aspiration. The nurse assesses the gastric residual volume to be 350 mL. The nurse determines which action is correct?
Monitoring the feeding closely.
A nurse is giving a client barium swallow test. What is the most important assessment a nurse would make to ensure that a client does not retain any barium after a barium swallow?
Monitoring the stool passage and its color.
Which of the following is a physiologic response to pain?
Pallor
The nurse has given an older adult an oral opioid for postoperative pain. What should the nurse do first to make the pain medication more effective?
Position the client for comfort.
A client is being treated in the ICU 24 hours after having a radical neck dissection completed. The client's serum calcium concentration is 7.6 mg/dL (1.9 mmol/L). Which physical examination finding is consistent with this electrolyte imbalance?
Presence of Trousseau sign
The nurse conducts education related to test preparation for a client scheduled to undergo an abdominal ultrasonography. The nurse should give the client which instruction?
Restrict eating of solid food for 8 to 12 hours before the test.
The nurse is participating in the care of a client who had a peripherally inserted central catheter (PICC) placed in the right arm. After catheter placement, the nurse should complete which action?
Send the client for a chest x-ray.
A patient with diabetes insipidus presents to the emergency room for treatment of dehydration. The nurse knows to review serum laboratory results for which of the diagnostic indicators?
Sodium level of 150 mEq/L
Specific disease processes and ingestion of certain foods and medications may change the appearance of the stool. If blood is shed in sufficient quantities into the upper gastrointestinal (GI) tract, it produces which change in the stool appearance?
Tarry-black
The physician has prescribed a hypotonic IV solution for a patient. Which IV solution should the nurse administer?
0.45% sodium chloride
The major carbohydrate that tissue cells use as fuel is
Glucose
The nurse is administering an analgesic to an older adult patient. Why is it important for the nurse to assess the patient carefully?
Older people are more sensitive to drugs.
A patient has a gastric sump tube attached to low intermittent suction. The nurse empties the suction collection chamber and records an output of 320 mL for this 8-hour shift. The record shows that the tube had been irrigated with 20 mL of normal saline twice this shift. What would be the actual output of the gastric sump tube?
280ml
Following a unilateral adrenalectomy, a nurse should assess for hyperkalemia as indicated by:
muscle weakness.
A client being treated for rheumatoid arthritis has been prescribed a glucocorticosteroid. How should the nurse best ensure this client's safety during treatment?
Ensure the client knows to taper down the dose if it is discontinued by the care provider.
A nurse is caring for an adult client with numerous draining wounds from gunshots. The client's pulse rate has increased from 100 to 130 beats per minute over the last hour. The nurse should further assess the client for which of the following?
Extracellular fluid volume deficit
Semi-Fowler position is maintained for at least which timeframe following completion of an intermittent tube feeding?
1 hour
A home care nurse is caring for a client with reports of epigastric discomfort who is scheduled for a barium swallow. Which statement by the client indicates an understanding of the test?
"I'll avoid eating or drinking anything 6 to 8 hours before the test."
The client has the intake and output shown in the accompanying chart for an 8-hour shift. What is the positive fluid balance?
260ml Intake includes all the components listed in the intake column, which amounts to 710 mL. The output, which is the urine of 450 mL, is subtracted from the total intake. This leaves 260 mL as a positive fluid balance.
A client was admitted to the unit with a diagnosis of hypovolemia. When it is time to complete discharge teaching, which of the following will the nurse teach the client and family? Select all that apply.
Drink at least eight glasses of fluid each day. Drink water as an inexpensive way to meet fluid needs. Respond to thirst
The nurse is caring for a client diagnosed with chronic obstructive pulmonary disease (COPD) and experiencing respiratory acidosis. The client asks what is making the acidotic state. The nurse is most correct to identify which result of the disease process that causes the fall in pH?
The lungs are not able to blow off carbon dioxide.
A client is prescribed methadone 10 mg three times a day for neuralgia following chemotherapy treatment. The client reports that he is experiencing constipation and asks the nurse for information about preventing constipation. The nurse recommends
increasing the amount of bran and fresh fruits and vegetables
The nurse performs an abdominal assessment. The nurse should perform the assessment in which order?
inspection, auscultation, percussion, palpation
Which term describes a gastric secretion that combines with vitamin B12 so that it can be absorbed?
intrinsic factor
A nurse is caring for a patient with a Salem sump gastric tube attached to low intermittent suction for decompression. The patient asks, "What's this blue part of the tube for?" Which response by the nurse would be most appropriate?
"It is a vent that prevents backflow of the secretions."
The nurse asks a client to point to where pain is felt. The client asks why this is important. What is the nurse's best response?
"Often the area of pain is referred from another area."
The client reports chest pain. The nurse uses which of the following questions to assess the pain further. Select all answers that apply.
"Please point to where you are experiencing pain." "Rate the pain on a scale of 0 to 10, with 10 being the worst possible pain." "How long have you experienced this pain?" "What aggravates your chest pain?"
The weight of a client with congestive heart failure is monitored daily and entered into the medical record. In a 24-hour period, the client's weight increased by 2 lb. How much fluid is this client retaining?
1 L
When administering a fentanyl patch, the last dose of sustained-release morphine should be administered at what point?
At the same time the first patch is applied
A nonresponsive client has a nasogastric tube to low intermittent suction due to gastrointestinal bleeding. It is most important for the nurse to
Auscultate lung sounds every 4 hours.
Which findings indicate that a client has developed water intoxication secondary to treatment for diabetes insipidus?
Confusion and seizures
A nurse is caring for a client receiving parenteral nutrition at home. The client was discharged from the acute care facility 4 days ago. What would the nurse include in the client's plan of care? Select all that apply.
Daily weights Intake and output monitoring Calorie counts for oral nutrients
A nurse is preparing a client with Crohn's disease for a barium enema. What should the nurse do the day before the test?
Encourage plenty of fluids.
The advance nurse practitioner, who is treating a client diagnosed with neuropathic pain, decides to start adjuvant analgesic agent therapy. Which medication is appropriate for the nurse practitioner to prescribe?
Gabapentin
A client is receiving parenteral nutrition (PN) through a peripherally inserted central catheter (PICC) and will be discharged home with PN. The home health nurse evaluates the home setting and would make a recommendation when noticing which circumstance?
No land line; cell phone available and taken by family member during working hours
The nurse is to obtain a stool specimen from a client who reported that he is taking iron supplements. The nurse would expect the stool to be which color?
black
The nurse prepares a client for a barium enema. The nurse should place the client on which diet prior to the procedure?
clear liquids day before
The client is taking oxycodone (Oxycontin) for chronic back pain and reports decreased pain relief when he began taking a herb to improve his physical stamina. The nurse asks if the herb is
ginseng
A client with cancer is being treated on the oncology unit for bilateral breast cancer. The client is undergoing chemotherapy. The nurse notes the client's serum calcium concentration is 12.3 mg/dL (3.08 mmol/L). Given this laboratory finding, the nurse should suspect that the
malignancy is causing the electrolyte imbalance.
The nurse is working with clients with digestive tract disorders. Which of the following organs does the nurse realize has effects as an exocrine gland and an endocrine gland?
pancreas
The nurse sees an order for a lidocaine 5% patch. What use is approved for by the US Food and Drug Administration for this patch
postherpetic neuralgia
A client admitted with acute anxiety has the following arterial blood gas (ABG) values: pH, 7.55; partial pressure of arterial oxygen (PaO2), 90 mm Hg; partial pressure of arterial carbon dioxide (PaCO2), 27 mm Hg; and bicarbonate (HCO3-), 24 mEq/L. Based on these values, the nurse suspects:
respiratory alkalosis.
Which of the following nursing interventions contributes to achieving a client's pain relief?
Collaborate with the client about his or her goal for a level of pain relief.
A client reports muscle cramps in the calves and feeling "tired a lot." The client is taking ethacrynic acid (Edecrin) for hypertension. Based on these symptoms, the client will be evaluated for which electrolyte imbalance?
hypokalemia
The nurse is obtaining data regarding the medication that the client is taking on a regular basis. The client states he is taking duloxetine, an antidepressant for the treatment of neuropathic pain. What type of therapy does the nurse understand the client is receiving?
Adjuvant drug therapy
A client with end-stage dementia is admitted to the orthopedic unit after undergoing internal fixation of the right hip. How should the nurse manage the client's postoperative pain?
Administer analgesics around the clock.
How should the administration of analgesics be scheduled to provide a uniform level of pain relief to a client?
Administering the analgesics every three hours
A client is recovering from percutaneous endoscopic gastrostomy (PEG) tube placement. The nurse
Administers an initial bolus of 50 mL water
The emergency department (ED) nurse is caring for a client with a possible acid-base imbalance. The physician has ordered an arterial blood gas (ABG). What is one of the most important indications of an acid-base imbalance that is shown in an ABG?
Bicarbonate
During a colonoscopy with moderate sedation, the patient groans with obvious discomfort and begins bleeding from the rectum. The patient is diaphoretic and has an increase in abdominal girth from distention. What complication of this procedure is the nurse aware may be occurring?
Bowel perforation
When a nurse asks a patient to describe the quality of the pain, what type of descriptive term does the nurse expect the patient to use?
Burning
While palpating a client's right upper quadrant (RUQ), the nurse would expect to find which structure?
Liver
With which condition should the nurse expect that a decrease in serum osmolality will occur?
kidney failure
