MS-Q1
A nurse is caring for a client who has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide? "Crushing the medication would release all the medication at once, rather than over time." "Crushing the medication might cause you to have a stomachache or indigestion." "Crushing the medication is a good idea, and i can mix it in some ice cream for you." "Crushing is unsafe, as it destroys the ingredients in the medication."
"Crushing the medication might cause you to have a stomachache or indigestion."
A nurse is reviewing information about the Health insurance Portability and Accountability Act (HIPAA) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further teaching? "Information about a client can be disclosed to family members at any time." "A client's address would be an example of personally identifiable information "HIPAA established regulations of individually identifiable health information in verbal, electronic, or written form. "HIPAA is a federal law, not a state law.
"Information about a client can be disclosed to family members at any time."
A patient who is recovering from an acute myocardial infraction (AMI) ask the nurse when sexual intercourse can be resumed. Which response by the nurse is best?
"Sexual activity uses about as much energy as climbing two flights of stairs."
A nurse is orienting a newly licensed nurse on the purpose of administering atracurium to a client who has acute respiratory distress syndrome (ARDS). Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? "This medication is given to treat infection." "This medication is given to decrease inflammation." "This medication is given to facilitate ventilation "This medication is given to reduce anxiety.
"This medication is given to facilitate ventilation
A nurse at an extended-care facility is Instructing a class of assistive personnel (AP) about client use of assistive devices during ambulation. Which of the following instructions should the nurse give the APs about the clients' use of a cane? "When the client moves, he should move the cane forward first. "The grip should be level with the client's waist." "The client should first move the strong leg, then the weak one." The client should hold the cane on the weak side of his body.
"When the client moves, he should move the cane forward first.
A nurse is caring for a client who is using a patient-controlled analgesia (CA) pump for postoperative pain management. The nurse enters the room to find the client asleep and his partner pressing the button to dispense another dose. Which of the following responses should the nurse make? "Your husband should decide when more medication is needed." It's a good idea to help make sure your husband can sleep comfortably." Why do you think your husband needs more medication when he is asleep? " Next time you think he needs more medication, call me and fill push the button.
"Your husband should decide when more medication is needed."
You have on hand hydromorphone (Dilaudid) 4 mg/ml. You need to administer 0.015 mg/kg to a patient who weighs 150 pounds. How many milliliters should you administer? Record your answer using two decimal places.
0.26 mL
A client is to receive enoxaparin 30 mg subcutaneously. Available is enoxaparin 40 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies.
0.8 ml
A patient has a bottle of warfarin (Coumadin) 5 mg tablets at home. After his most recent international normalized ratio (INR), the doctor calls and tells him to take 7.5 mg/day. How many tablets (scored) should the patient take? Round answer using one decimal place:
1.5 tab
A nurse is documenting the intake for a client who is scheduled for an abdominal computed axial tomography (CT) scan. Prior to the scan, the client consumes 12 oz sodium diatrizoate and meglumine diatrizoate. The client has an IV of Ds NS running at 75 mL/hr from 0700 until 1200. The IV runs at 30 mL/hr from 1200 to 1500. At 1500, the client has 6 oz juice. How many mL should the nurse document as the client's intake for the shift?
1005
A nurse is caring for a client who has a pulmonary embolism and has a new prescription for enoxaparin 1.5m/kg/dose subcutaneous every 12. hr. The client weighs 245 lbs. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero If it applies. Do not use a trailing zero.)
167
A nurse is preparing to administer a continuous heparin infusion at 1600 units/hr. Available is heparin 25,000 units in dextrose 5% in water (DW) 500 mL. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies.
32ml/hr
A nurse is caring for a client who has diabetes and a new prescription for 14 units of regular insulin and 28 units of PH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe? 14 Units 28 units 32 units 42 units
42 units
Order: Heparin 15 units/kg/hr IV drip. Supply: Heparin 25,000units/250 mL. The patient weighs125 Ibs. How many mi per hour will the nurse infuse? Round to the nearest tenth.
9.4 ml/hr
A nurse is caring for a client who develops a pulmonary embolism. Which of the following interventions should the nurse implement first? Give morphine IV. Initiate cardiac monitoring. Administer oxygen therapy. Start an IV infusion of lactated Ringer's.
Administer oxygen therapy.
A nurse is caring for a client who develops ARDS. The nurse is aware that the disease is characterized by? Progressive loss of lung compliance and increasing hypoxia Cystic fibrosis Atelectasis Amiodarone administration
Amiodarone administration
A nurse in an emergency department is assessing a client who is having a pneumothorax. Which of the following manifestations should the nurse expect? Air has escaped from the lung into the pleural space and caused increased intrapleural pressure making it difficult to ventilate the patient. Anxiety and dyspnea Nausea and epigastric distress Chest pain unrelieved by nitrates Pallor and diaphoresis
Anxiety and dyspnea Nausea and epigastric distress Chest pain unrelieved by nitrates Pallor and diaphoresis
A nurse is preparing to perform hand hygiene. Which of the following actlons should the nurse take? Rub hands and arms to dry. hold the hands higher than the elbows Apply 4 to 5 mL of liquid soap to the hands Adjust the water temperature to feel hot.
Apply 4 to 5 mL of liquid soap to the hands
A nurse is caring for a client who has an endotracheal tube and is receiving mechanical ventilation. The client pulls out his endotracheal tube. Which of the following actions should the nurse take first? Assess the client's airway. Suction the client's mouth. Elevate the client's head of bed. Prepare the client for reintubation.
Assess the client's airway.
A nurse is caring for a 76-year-old client who has recently placed central venous catheter and reports hearing a gurgling sound on the side of the catheter insertion. Which of the following complications should the nurse suspect?
Catheter migration
A nurse is caring for a client who is receiving a continuous I infusion of heparin. Which of the following actions should the nurse take? Check the activated partial thromboplastin time (aPTT) every 4 hr. Administer 50,000 units of heparin by IV bolus every 12 hr. Use IV tubing specific for heparin sodium when administering the infusion. Have vitamin K available in the nursing unit.
Check the activated partial thromboplastin time (aPTT) every 4 hr.
The nurse is assessing the client's respiratory pattern and notes periods of deep breathing alternating with periods of apnea. When documenting this assessment finding, which term is the most appropriate for the nurse to use? Cheyne-Stokes Tachypnea Obstructive breathing Hypoventilation
Cheyne-Stokes
Respiratory effort usually exhibited by the patient with cerebral brain damage is called: Ataxic respiration Kussmaul breathing Paroxysmal nocturnal dyspned Cheyne-Stokes respiration
Cheyne-Stokes respiration
A nurse is caring for a client who is unconscious and has a breathing pattern characterized by alternating periods of hyperventilation and apnea. The nurse should document that the client has which of the following respiratory alterations? Stridor Apneustic respirations Kussmaul respirations Cheyne-Stokes respirations
Cheyne-Stokes respirations
SATA A 58 yr old patient who has been in the ICU for 6 days has disturbed sensory perception from sleep deprivation. Which actions should the nurse include in the plan of care? Select all that apply. There are 2 correct answers. Silence the alarms on the cardiac monitors to allow 30- to 40 minute. Never Eliminate assessments between 2200 and 0600 to allow uninterrupted sleep. No Administer prescribed sedatives or opioids at bedtime to promote sleep. No Cluster nursing activities. Providing uninterrupted rest periods will minimize sleep-cycle disruption Partners, whether legal or not. No
Cluster nursing activities. Providing uninterrupted rest periods will minimize sleep-cycle disruption
NGN. 1200 - Client sitting in recliner conversing with family visiting at bedside. Chest tube drainage system Is connected to wall-suction in the dependent position, continuous bubbling noted in both the suction control chamber and the water seal chamber, 20 mL of serosanguineous drainage noted over the last hour in the collection chamber, and the dressing is dry and intact.
Complete the following sentence using the list of options. The nurse knows there is likely an air leak due to the presence of continuous bubbling in the water seal chamber
A nurse is caring for a client who has a new chest tube in place to closed-chest water-seal drainage and suction. The nurse should observe the client for which of the following indications of a problem in the drainage system? Fluctuations in the fluid level in the water-seal chamber Continuous bubbling in the water-seal chamber Constant bubbling in the suction-control chamber Occasional bubbling in the water-seal chamber
Continuous bubbling in the water-seal chamber
A nurse is caring for a client who has been receiving oxygen therapy for several days. When assessing a client, the nurse should identify which of the following findings as an indication of an adverse effect of oxygen therapy?
Cracks in oral mucosa membranes
A nurse is caring for a client who When assessing the client, the nurse should identify which of the following findings as an Excessive pulmonary secretions. Tachycardia. Cracks in oral mucous membranes. Poor skin turgor.
Cracks in oral mucous membranes.
A nurse is caring for a client who has been receiving oxygen therapy for several days. When assessing the client, the nurse should identify which of the following findings as an indication of an adverse effect of oxygen therapy. Excessive pulmonary secretions. Tachycardia. Cracks in oral mucous membranes. Poor skin turgor.
Cracks in oral mucous membranes.
Which of the following upper respiratory drugs cause local vasoconstriction? Decongestants Do not know Tylenol Insulin
Decongestants
When evaluating a 62 yr old patient with a central venous catheter, the nurse observes that the insertion site is red and tender to touch and the patient's temperature is 101.8° F. What should the nurse prioritize to do next? Discontinue the catheter and culture the tip. Use the catheter only for fluid administration. Change the flush system and monitor the site Check the site more frequently for any swelling
Discontinue the catheter and culture the tip.
When evaluating a 62 yr old patient with a central venous catheter, the nurse observes that the insertion site is red and tender to touch and the patient's temperature is 101.8° F. What should the nurse prioritize to do next? Discontinue the catheter and culture the tip. Use the catheter only for fluid administration. Change the flush system and monitor the site Check the site more frequently for any swelling
Discontinue the catheter and culture the tip.
A patient who has been receiving include in the plan of care? Give low-molecular-weight heparin (LMWH) Administer prescribed warfarin (Coumadin) Prepare for platelet transfusion. Discontinue the heparin infusion
Discontinue the heparin infusion
A patient who has been receiving IV heparin infusion and oral warfarin (Coumadin) for a deep vein thrombosis (DVT) is diagnosed with heparin-induced thrombocytopenia (HIT) when the platelet level drops to 110,000/pL. which action will the nurse include in the plan of care? Give low-molecular-weight heparin (LMWH) Administer prescribed warfarin (Coumadin) Prepare for platelet transfusion. Discontinue the heparin infusion
Discontinue the heparin infusion
NGN Patient presents with a pulmonary embolism. Which finding Is expected in this condition? Low PaO2 Tracheal deviation Asymmetrical chest expansion Dyspnea Tachycardia Feeling of impending doom
Dyspnea Tachycardia Feeling of impending doom
A nurse is providing discharge teaching for a client who has pulmonary edema and is about to start taking furosemide. Which of the following instructions should the nurse include? Expect some swelling in the hands and feet. Take aspirin if headaches develop. Take the medication at bedtime. Eat foods that contain plenty of potassium.
Eat foods that contain plenty of potassium.
A nurse is preparing to administer three liquid medications to a client who has an NG feeding tube with continuous enteral feedings. Which of the following actions should the nurse take? Flush the NG feeding tube with 30 mL of water immediately following medication administration Dilute each medication with 10 mL of tap water. Mix the three medications together prior to administering. Maintain the head of the bed in a flat position for 30 min following medication administration.
Flush the NG feeding tube with 30 mL of water immediately following medication administration
A nurse is preparing a client for transfer to the ICU for placement of a pulmonary artery catheter. The nurse should explain to the client that this catheter is used to monitor which of the following conditions? Spinal cord perfusion Hemodynamic status Renal function intracranial pressure
Hemodynamic status
A nurse is teaching a class about oxygen transport in the cardiopulmonary system. Which of the following transports oxygen in the blood? Neutrophils Lymphocytes Platelets Hemoglobin
Hemoglobin
A nurse is caring for a client who has just developed a pulmonary embolism. Which of the following medications should the nurse anticipate administering? Dexamethasone Atropine Heparin Furosemide
Heparin
NGN. The nurse is caring for a client who is intubated and mechanically ventilated. Identify the expected alarm for the following events. Only one correct answer per row. High-Pressure Alarm: Kink in tubing Secretions Low-Pressure Alarm: Endotracheal tube cuff leak Unplanned extubation Apnea: RR is 0
High-Pressure Alarm: Low-Pressure Alarm: Apnea:
A recently admitted 36 yr old patient who has sustained multiple traumas develops a low CVP pressure. Which of the following interpretations will alert the nurse of this change? Hypovolemia Intracardiac shunt Fluid overload Left ventricular failure
Hypovolemia
After surgery for an abdominal aortic aneurysm, a patient's central venous pressure (CVP) monitor indicates low pressures. Which action should the nurse take? Administer IV diuretic medications. Increase the IV fluid infusion per protocol. Elevate the head of the patient's bed to 45 degrees. Increase the infusion rate of IV vasodilators.
Increase the IV fluid infusion per protocol.
A nurse is caring for a client who has a chest tube connected to a closed drainage system and needs to be transported to the x-ray department. Which of the following actions should the nurse take? Disconnect the chest tube from the drainage system during transport. Keep the drainage system below the level of the client's chest at all times. Empty the collection chamber prior to transport. Clamp the chest tube prior to transferring the client to a wheelchair.
Keep the drainage system below the level of the client's chest at all times.
A nurse is assessing a client who had left femoral cardiac angiography. Identify where the nurse will palpate to assess the most distal pulse on the affected side. (Selectable areas, or "Hot Spots," are outlined in the artwork below).
Left Pedal
An intubated client's oxygen saturation has dropped to 86%. What action by the nurse takes priority? Ensure all connections are patent. Suction the endotracheal tube. Listen to the clients lung sounds. Determine if the tube is kinked to coiled.
Listen to the clients lung sounds.
NGN Patient presents with a pulmonary embolism. Which finding Is expected in this condition? Low PaO2 Tracheal deviation Asymmetrical chest expansion has been receiving oxygen therapy for several days. indication of an adverse effect of oxygen therapy Dyspnea Tachycardia Feeling of impending doom
Low PaO2 Dyspnea Tachycardia Feeling of impending doom
The nurse performing a respiratory assessment on her client and hears rhonchi in bilateral lobes. Which is the best description for this adventitious sound? High pitched, short, and crackling. Low pitched grating. rubbing. High pitched and continuous. Low pitched, continuous, snoring or rattling.
Low pitched, continuous, snoring or rattling.
Breathing is controlled by what part of the CNS? Mean arterial pressure is 62 mm Hg Heart rate is 58 beats/min. Medulla Oblongata Pulmonary artery
Medulla Oblongata
Name the medication that would be contraindicated for a patient receiving contrast dye during any procedure with IV contrast?
Metformin
A nurse is assessing a client who has a pneumothorax with a chest tube in place. For which of the following findings should the nurse notify the provider? Bubbling of the water in the water seal chamber with exhalation Evelets are not visible Crepitus in the area above and surrounding the insertion site Movement of the trachea toward the unaffected side
Movement of the trachea toward the unaffected side
NGN. Client is intubated on mechanical ventilation in the intensive care unit. What Interventions can the nurse perform to reduce the risk of ventilator-associated pneumonia VAP? (Select All That Apply) Oral care with chlorhexidine W Suction as needed Keep HOB elevated » 30 - 45 degrees Strict hand hygiene Ambulate the patient daily Turn the client every 4 hours
Oral care with chlorhexidine W Suction as needed Keep HOB elevated » 30 - 45 degrees Strict hand hygiene Ambulate the patient d
A nurse is caring for a client who reports a new onset of severe chest pain. Which of the following actions should the nurse take to determine if the client is experiencing a myocardial infarction?
Perform a 12-lead ECG
A nurse is reviewing the laboratory data on a client who has a new prescription for heparin for treatment of a pulmonary embolism. Which of the following data should the nurse report to the provider? Partial thromboplastin time (PT) 65 seconds Platelets 74,000 Hematocrit 45% White blood cell count 8,000/mm
Platelets 74,000
While palpating respiratory expansion on a client in the emergency room the nurse notes movement on only one side of the chest. What is the most likely indication of this finding? Pain. Pneumonia. Bronchitis Pneumothorax
Pneumothorax
What action by a new intensive care unit staff nurse would indicate chat the nurse educator's teaching about arterial pressure monitoring has been effective? Ensures that the patient is supine with the head of the bed flat for all readings. Positions the zero-reference stopcock line level with the phlebostatic axis. Rechecks the location of the phlebostatic axis with changes in the patient's position. Balances and calibrates the monitoring equipment every 2 hours.
Positions the zero-reference stopcock line level with the phlebostatic axis.
A nurse is caring for a client who is nurse plan to Vitamin K Glucagon Protamine sulfate Acetylcysteine
Protamine sulfate
A nurse is caring for a client who is receiving heparin by continuous IV infusion. Which of the following medications should the nurse plan to administer in the event of an overdose? Vitamin K Glucagon Protamine sulfate Acetylcysteine
Protamine sulfate
A nurse is caring for a patient who is orally intubated and receiving mechanical ventilation. To decrease the risk for ventilator-associated pneumonia, which action will the nurse include in the plan of care? Select all that apply Provide oral care daily with chlorhexidine (0.12%) solution obtain arterial blood gases daily. Provide a "sedation holiday" daily. Elevate the head of the bed to at least 30 degrees Give prescribed pantoprazole (Protonix).
Provide oral care daily with chlorhexidine (0.12%) solution Provide a "sedation holiday" daily. Elevate the head of the bed to at least 30 degrees Give prescribed pantoprazole (Protonix).
A nurse is teaching a class about pulmonary circulation. The nurse should include that blood flows from the heart to the lungs from the right ventricle starting from which of the following locations? Left atrium Left ventricle Pulmonary artery Pulmonary veins
Pulmonary artery
Which of the following is a hallmark characteristic of acute respiratory distress syndrome (ARDS)? Refractory Hypoxemia Hyperventilation Shortness of breath Change in level of consciousness
Refractory Hypoxemia
The patient is admitted with pneumothorax. The ABG shows Ph 7.20. What should the nurse know that the and PaC02 50 what does this Indicates? Myocardia injury Bowel Obstruction Respiratory Acidosis Normal pacemaker function
Respiratory Acidosis
A nurse is caring for a client whose arterial blood gas results show a pH of 7.23; PaCO2 of 61 and HCO3 of 25 mEq/L. The nurse should identify that the client is experiencing which of the following acid-base imbalances? Metabolic acidosis, partially compensated Respiratory acidosis, uncompensated Respiratory alkalosis, fully compensated Metabolic alkalosis, uncompensated
Respiratory acidosis, uncompensated
A nurse is caring for a client whose arterial blood gas results show a pH of 7.23; PaCO2 of 61 and HCO3 of 25 mEq/L. The nurse should identify that the client is experiencing which of the following acid-base imbalances? Metabolic acidosis, partially compensated Respiratory acidosis, uncompensated Respiratory alkalosis, fully compensated Metabolic alkalosis, uncompensated
Respiratory acidosis, uncompensated
The client's respiratory assessment reveals loud, low pitch snoring sounds during inspiration and expiration. Which term best represents these sounds? Crackles wheezes Rhonci Normal
Rhonchi
Which electrocardiographic (ECG) change is the most important for the nurse to report to the healthcare provider when caring for a patient with chest pain?
ST-segment elevation
A patient whose heart monitor shows systole. The patient is apneic, and has no palpable pulses. What action should the nurse take next? Provide supplemental 02 via non-rebreather mask. Perform synchronized cardioversion Give atropine per agency dysrhythmia protocol. Start cardiopulmonary resuscitation (CPR)
Start cardiopulmonary resuscitation (CPR)
A nurse is monitoring a client who reports having chills and back pain during a blood transfusion. Which of the following actions is the nurse's priority? Stopping the transfusion Covering the client with a blanket Assessing the client's skin for a rash Notifying the provider
Stopping the transfusion
Which of the following allows the alveoli sac to stay open and allows for the exchange of gases? Don't know Histamines ATP Surfactant
Surfactant
Describe the MOA for norepinephrine IV infusion. Which patient assessment finding indicates that the infusion rate may need to be adjusted?
Systemic vascular resistance (SVR) is elevated
A nurse on a long-term care unit is creating a plan of care for a client who has Alzheimer's disease. Which of the following interventions should the nurse include in the plan? Talk the client through tasks one step at a time. Limit time for the client to perform activities. Provide an activity schedule that changes from day to day. Rotate assignment of daily caregivers.
Talk the client through tasks one step at a time.
A nurse is administering nasal decongestant drops for a client. Which of the following actions should the nurse take? Assist the client to a side-lying position. Tell the client to blow her nose gently before the installation. instruct the client to stay in the same position for 2 min Hold the dropper 2 cm (1 in) above the naris
Tell the client to blow her nose gently before the installation.
The nurse assesses a client with dyspnes, decreased breath sounds, tracheal deviation, and pulse oximetry reading of 86%. What is the nurse's interpretation of these findings? Acute respiratory distress syndrome Tension pneumothorax Flail chest Pulmonary contusion
Tension pneumothorax
The nursing student is asked to demonstrate the Allen test on a fellow student. which of the following best describes the Allen test? Yellowish cholesterol deposits seen on the evelids and are indicative of premature atheroscierosis. Diagnostic maneuver in which pain may increase with sharp dorsiflexion of the foot. A condition in which the arterioles is the fingers develop spasms, causing intermittent skin palior or cyanosis and then rubor (red colon. Test used to determine patency of the radial and ulnar arteries
Test used to determine patency of the radial and ulnar arteries
A client has the following arterial blood gas values: pH 7.52, Pa02 42 mm Hg, PaCO2 28 mm Hg. HCO3 24 mEq/L Based upon the client's Pa02, which of the following conclusions would be accurate? The oxygen level is low but poses no risk for the client. • The client is severely hypoxic. The client's Pa02 level is within normal range. The client requires oxygen therapy with very low oxygen concentrations.
The client is severely hypoxic.
A nurse is caring for a client who is postoperative. The nurse should base her pain management interventions primarily on which of the following methods of determining the intensity of the client's pan? Visual observation for nonverbal signs of pain The nature and invasiveness of the surgical procedure The client's self-report of pain severity Vital sign measurement
The client's self-report of pain severity
Which finding by the nurse caring for a patient with a right radial arterial line indicates a need for the nurse to take immediate action? The flush bag and tubing were changed 2 days previously. The system is delivering 3 mL of flush solution per hour, The mean arterial pressure (MAP) Is 77 mm Hg. The right-hand feels cooler than the left hand
The right-hand feels cooler than the left hand
Which finding by the nurse caring for a patient with a right radial arterial line indicates a need for the nurse to take immediate action? The flush bag and tubing were changed 2 days previously. The system is delivering 3 mL of flush solution per hour, The mean arterial pressure (MAP) Is 77 mm Hg. The right-hand feels cooler than the left hand
The right-hand feels cooler than the left hand
NGN. A nurse is caring for a client who is scheduled for surgery. A nurse is providing preoperative teaching to a client about pain management using a patient-controlled analgesia (PCA) system. Which of the following 3 statements should the nurse include? There is minimal risk of an overdose of pain medication while using the PCA pump." Your family member should push the PCA button for you while you are (sleeping." "Push the button on the PCA prior to your pain level becoming severe so you can remain comfortable.* You will still have to request pain medication from the nurse from time to "Using the PCA regularly will provide a consistent level of pain relief."
There is minimal risk of an overdose of pain medication while using the PCA pump." "Push the button on the PCA prior to your pain level becoming severe so you can remain comfortable. "Using the PCA regularly will provide a consistent level of pain relief."
What is the best initial action by the nurse to verify the correct placement of an oral endotracheal tube (ET) after insertion? Auscultate for bilateral breath sounds. Obtain a portable chest x-ray Use an end-tidal CO2 monitor. Observe for symmetrical chest movement.
Use an end-tidal CO2 monitor.
The nurse obtains a rhythm strip on a patient who has a myocardial infraction and makes the following analysis: no visible P waves, PR interval not measurable, ventricular rate of 162, R-R interval regular, and QRS complex wide and distorted, and QRS duration of 0. 18 second. The nurse interprets the patient cardiac rhythm as
Ventricular tachycardia
After completing a respiratory assessment, the nurse documents: APT diameter 1:2, symmetrical chest expansion, respiratory rate 16 and regular. vesicular breath sounds. Interpreting these data, the nurse: percusses the lung fields for areas of hyperresonance considers these normal findings suspects a potential respiratory infection performs a more in-depth respiratory assessment because of the abnormal breath sounds
considers these normal findings
Analyze the following ABG: pH: 7.31 PaCO2: 26 mm Hg HCO3: 13 mm Hg metabolic alkalosis, uncompensated respiratory alkalosis, partially compensated metabolic acidosis partially compensated respiratory acidosis, uncompensated
metabolic acidosis partially compensated
Which of the following statements is an example of the effect of aging, illness, or trauma on self-concept? most people accept the inevitability of illness society devalues, aging and chronic illness few people take a healthy body for granted society values the wisdom of aging
society devalues, aging and chronic illness
Ngn In which situation would it be appropriate for a critical care nurse to use an arterial monitoring access to meet the client's needs? Select all that apply. •When additional access is needed to administer blood products for hypovolemia. •To do daily blood draws for studies in a client with severe endocarditis in acute pain. •To do frequent arterial blood gases for a client in acute respiratory failure. •To do continuous monitoring of blood gases in a client with malignant hypertension.
•When additional access is needed to administer blood products for hypovolemia. •To do daily blood draws for studies in a client with severe endocarditis in acute pain. •To do frequent arterial blood gases for a client in acute respiratory failure. •To do continuous monitoring of blood gases in a client with malignant hypertension.
