NU 372 Final Exam Prep

Which instructions about the use of nitroglycerin to prevent angina will the nurse provide to a client?

"Before physical activity, place one tablet under the tongue, and repeat the dose in 5 minutes if pain occurs."

To reduce the incidence of human immunodeficiency virus (HIV) transmission, which basic strategies would the nurse teach a health class? Select all that apply. One, some, or all responses may be correct.

-condoms -abstinence

Which information obtained by the nurse about a client would represent risk factors for the client's admission diagnosis of hypertension? Select all that apply. One, some, or all responses may be correct.

-occasional cocaine use -African American heritage

A client has a history of a persistent cough, hemoptysis, unexplained weight loss, fatigue, night sweats, and fever. Which risk would be assessed?

HIV

When the nurse in the coronary care unit (CCU) identifies ventricular fibrillation on a client's cardiac monitor, which intervention is the priority?

Defibrillate the client.

A client who is receiving atenolol for hypertension frequently reports feeling dizzy. Which effect of atenolol is responsible for this response?

Blocking the adrenergic response

When a client is admitted to the coronary care unit with a diagnosis of ST segment elevation myocardial infarction, how will the nurse expect the client to describe the pain?

Severe, intense chest pain

Which actions transmit the human immunodeficiency virus (HIV)? Select all that apply. One, some, or all responses may be correct.

Sharing syringe needles Breast-feeding a newborn anal intercourse

The nurse is providing counseling to a client with the diagnosis of systemic lupus erythematosus (SLE). Which recommendations are essential for the nurse to include? Select all that apply. One, some, or all responses may be correct.

"Wear a large-brimmed hat." "Take your temperature daily." "Balance periods of rest and activity."

Which client has a higher risk for contracting the human immunodeficiency virus (HIV) infection?

A client who shares equipment to snort or smoke drugs

Which intervention would the nurse teach the client who has rheumatoid arthritis to alternate with periods of rest?

Active exercises

Which medication is used to treat Helicobacter pylori infection? Select all that apply. One, some, or all responses may be correct.

Amoxicillin Tetracycline Pantoprazole Metronidazole Bismuth subsalicylate

When a client exhibits severe bradycardia, which type of medication will the nurse be prepared to administer?

Anticholinergic

When an older client with heart failure is transferred from the emergency department to the medical service, which would the nurse on the unit do first?

Assess the client's heart and lung sounds.

When a client who has had a myocardial infarction suddenly develops a heart rate of 120 beats/minute, which action would the nurse take first?

Check blood pressure.

Which characteristic of urine changes in the presence of a urinary tract infection (UTI)?

Clarity

Which finding about a client's angina is most important for the nurse to communicate to the health care provider?

Continues after rest and nitroglycerin

A client with a methicillin-resistant Staphylococcus aureus (MRSA) infected wound is scheduled for a computed tomography (CT) scan. To ensure client and visitor safety during transport, the nurse would implement which precaution?

Cover the infected site with a dressing.

How would the nurse explain the purpose of standard precautions to the nursing assistant on a surgical unit?

Decrease the risk of transmitting unidentified pathogens

A client with active tuberculosis is walking down the hall to obtain a glass of juice from the kitchen, even after having received education regarding airborne precautions. Which nursing intervention would the nurse implement at this time?

Explore what the airborne precautions mean to the client.

Which parameter would the nurse assess in a client with right-sided heart failure? Select all that apply. One, some, or all responses may be correct.

Fluid volume

A client with a diagnosis of myocardial infarction asks the nurse, "What is causing the pain I am having?" Which explanation would the nurse give?

Inadequate oxygenation of the myocardium

When preparing to assess a client with active tuberculosis, which piece of protective equipment is necessary for the nurse before entering the client room?

N95 Mask

When caring for a client who is hospitalized for an acute myocardial infarction, which prescription by the health care provider would the nurse question?

Rectal suppository as needed for constipation

Which finding for a client who has a diagnosis of paroxysmal atrial fibrillation is most important to report quickly to the health care provider?

Right arm weakness

If the public health department issues a statement predicting a particularly difficult influenza season, how might this affect client care?

Staff may decide to stay at home instead of go to work.

A client with a continuous intravenous (IV) heparin drip is prescribed IV vancomycin every 12 hours. Which action will the nurse take when it is time to administer the vancomycin?

Start a second IV line for the vancomycin and continue the heparin as prescribed.

A client who has paroxysmal supraventricular tachycardia reports a mild "fluttering feeling" in the chest and has a blood pressure of 110/55 mm Hg. Which potential treatment by the health care provider would the nurse question?

Synchronized cardioversion

Which action is essential for the nurse to include in the plan of care for a client with atrial fibrillation?

Take pulse apically for a full minute.

Which data would the nurse document for a client who returns to the clinic with induration of the skin 48 hours after receiving a purified protein derivative (PPD) test? Select all that apply. One, some, or all responses may be correct.

The client has been exposed to tuberculosis.

Which action by an uninfected individual would not pose a risk of exposure to human immunodeficiency virus (HIV)?

The individual donates a pint of blood to the blood bank.

A health care provider prescribes a diuretic for a client with hypertension. Which mechanism of action explains how diuretics reduce blood pressure?

They reduce the circulating blood volume.

Which clinical manifestations are associated with a diagnosis of tuberculosis? Select all that apply. One, some, or all responses may be correct.

anorexia, hemoptysis, night sweats

When a client has a prescription for warfarin, which foods would the nurse teach the client to limit? Select all that apply. One, some, or all responses may be correct.

broccoli and spinach

A child being treated with cardiac medications developed vomiting, bradycardia, anorexia, and dysrhythmias. The nurse understands which medication toxicity is responsible for these symptoms?

digoxin

A client with left ventricular heart failure and supraventricular tachycardia is prescribed digoxin 0.25 mg daily. Which changes would the nurse expect to find if this medication is therapeutically effective? Select all that apply. One, some, or all responses may be correct.

diuresis, decreased edema, decreased pulse rate

Which statement is inaccurate regarding the mechanisms of antiviral medications to control human immunodeficiency virus (HIV) infections?

"Saquinavir blocks the fusion between HIV and the host cell."

A client with tuberculosis receives instructions regarding isoniazid (INH) therapy from the assigned nurse. Which client statement indicates a misunderstanding of the content?

"I should apply sunscreen and wear sun-protective clothing while going outside."

Place the pathophysiologic process of a tuberculosis (TB) infection in the correct order.

1. TB bacillus in the lungs creates a granulomatous inflammation. 2.Collagen, fibroblasts, and lymphocytes surround the granulomatous inflammation 3.Caseation necrosis occurs in the center of the lesion. 4.Areas of caseation undergo resorption, degeneration, and fibrosis. 5.Necrotic areas calcify or liquefy.

When caring for a client with symptomatic bradycardia caused by heart block, the nurse will anticipate the need to teach the client about which treatment option?

Demand pacemakers

Which action by the nurse is mostimportant when preparing for cardioversion of a client with atrial fibrillation?

Set synchronizer switch on defibrillator to the "on" position.

Which topics would the nurse include in teaching for a client with a new diagnosis of hypertension? Select all that apply. One, some, or all responses may be correct.

Use of a home blood pressure monitor Adverse effects of tobacco on blood pressure Benefits of moderate daily exercise

When teaching a client with heart failure about signs and symptoms that indicate a need to contact the primary health care provider, which clinical manifestations would the nurse include? Select all that apply. One, some, or all responses may be correct.

extreme fatigue coughing at night difficulty breathing

A client was prescribed a medication for pregnancy-induced hypertension and later developed muscle weakness, edema, and nausea. Which medication was administered to the client to treat pregnancy-induced hypertension?

magnesium sulfate

Which instruction would the nurse share with the client receiving etanercept therapy for rheumatoid arthritis?

report site reaction

When teaching a client with atrial fibrillation about a new prescription for warfarin, the nurse will include information about which vitamin?

vitamin K

Metoprolol is prescribed for a client with hypertension. The nurse monitors the client for which adverse effect?

Bradycardia

The registered nurse (RN) is caring for a client who is on isolation precautions. Which tasks can be safely assigned to the nursing assistive personnel? Select all that apply. One, some, or all responses may be correct.

Bringing equipment to the client's room Transporting the client to a diagnostic test

The nurse provides dietary education for a client with hypertension. The nurse recommends consuming foods that are low in natural sodium. Which item selected by the client indicates correct understanding of the teaching?

fruits

Which medication would be prescribed to reduce hypertension in a pregnant client?

magnesium sulfate

A client with chronic venous insufficiency has ankle edema. Which action would the nurse take?

Elevate the legs.

Which finding on an electrocardiogram for a client complaining of chest pain indicates possible acute myocardial infarction?

Elevated ST segments

A client with gestational hypertension is receiving education from the nurse in self-care. Which instruction would the nurse give for this client?

Ensure adequate sodium intake

Which clinical manifestation is associated with cellulitis?

Lymphadenopathy

Which instruction indicates a lack of understanding of a nurse teaching a human immunodeficiency virus (HIV)-positive client about strategies to prevent opportunistic infections?

"Reuse cups after washing them with warm soapy water."

Which information will the employee health nurse include when teaching about ways to prevent transmission of influenza in the workplace? Select all that apply. One, some, or all responses may be correct.

-Sneeze or cough into the upper sleeve. -Use alcohol-based hand sanitizers after blowing the nose. -Turn the head away from others when coughing or sneezing.

The nurse is interviewing a client who was diagnosed with systemic lupus erythematosus (SLE). Which clinical findings to this disease would the nurse expect the client to exhibit? Select all that apply. One, some, or all responses may be correct.

-butterfly facial rash -inflammation of the joints

Which potential clinical manifestations would the nurse associate with a client diagnosed with systemic lupus erythematosus (SLE)? Select all that apply. One, some, or all responses may be correct.

-joint pain -facial rash -pericarditis

Which clinical manifestations may indicate a client has systemic lupus erythematosus (SLE)? Select all that apply. One, some, or all responses may be correct.

-pericarditis -discoid lesions -pleural effusions

A client with tuberculosis asks the nurse how long medication therapy will be continued. Which time interval is would the nurse provide?

6 to 12 months

Which of these clients seen at a health fair will be most at risk for hypertension?

62-year-old African American man

A 50-year-old client has difficulty communicating because of expressive aphasia after a cerebrovascular accident (CVA, also known as a "brain attack"). When the nurse inquired about the client's feelings, the spouse responded. Which communication strategy would the nurse use to address this behavior?

Acknowledge the spouse, but look at the client for a response.

Which laboratory value would the nurse use to determine whether a client is receiving a therapeutic dose of intravenous heparin?

Activated partial thromboplastin time (APTT) is 70 seconds

A client taking multiple medications for hypertension develops a persistent, hacking cough. Which antihypertensive medication class would the nurse identify as the likely cause of the cough?

Angiotensin-converting enzyme (ACE) inhibitors

A client is admitted to the hospital, and benazepril is prescribed for hypertension. Which is an appropriate nursing action for clients taking this medication?

Assess for dizziness.

A client is admitted to the hospital with a long history of uncontrolled hypertension. Which laboratory result will be most important for the nurse to review?

Blood urea nitrogen

Which strategies would the nurse use to reduce pain during or after vaccination in a child? Select all that apply. One, some, or all responses may be correct.

Applying topical anesthetic Providing tactile stimulation Holding the child upright during vaccination

When a client in the coronary care unit develops ventricular tachycardia, which action will the nurse take first?

Assess client pulse and blood pressure.

To prevent excessive bruising when administering subcutaneous heparin, which technique will the nurse employ?

Avoid massaging the injection site after the injection.

When a client's cardiac monitor shows ventricular tachycardia, which action would the nurse take first?

Check for a pulse.

The client with congestive heart failure is receiving furosemide 80 mg once daily. Which data collection assessment would be performed to evaluate medication effectiveness? Select all that apply. One, some, or all responses may be correct.

Daily weight Intake and output Monitor for edema Daily pulse oximetry Auscultate breath sounds

A beta blocker is prescribed for the client with persistent ventricular tachycardia. Which response indicates that the beta blocker is working effectively?

Decreased heart rate

A client with hypertension has received a prescription for metoprolol. Which information will the nurse include when teaching this client about metoprolol?

Do not abruptly discontinue the medication.

A client with supraventricular tachycardia (SVT) has a heart rate of 170 beats/minute. After treatment with diltiazem, which assessment indicates to the nurse that the diltiazem is effective?

Heart rate of 98 beats/minute

Which intervention would the nurse recommend to decrease tuberculosis (TB) in the community? Select all that apply. One, some, or all responses may be correct.

Improving financial resources Eliminating overcrowded housing Initiating needle-sharing programs Improving access for food pantries Providing barrier contraceptive devices

Which action would the nurse perform when a client is in ventricular fibrillation? Select all that apply. One, some, or all responses may be correct.

Initiating CPR Assessing the EKG Using a defibrillator Obtaining electrolytes Administering epinephrine

Which nursing intervention is the priorityaction when admitting a client to the emergency department during cardiac arrest from ventricular fibrillation?

Initiating defibrillation

A client manifests right-sided hemianopsia as a result of a cerebrovascular accident (CVA, also known as a "brain attack"). Which goal would the nurse include in the client's plan of care?

Instruct the client to scan surroundings.

The registered nurse instructs a new employee about providing care for a hospitalized client with a human immunodeficiency (HIV) infection. Which action made by the new employee indicates effective learning?

Keeping a dedicated disposable glove box in the client's room

When a client with a history of heart failure arrives for a scheduled clinic appointment and has gained 6 lb (2.7 kg), which nursing action has the highest priority?

Listen to the client's breath sounds.

Which organism is a common opportunistic infection in a client infected with human immunodeficiency virus (HIV)?

Oropharyngeal candidiasis

Which evidenced-based nursing intervention links to reducing catheter associated urinary tract infections (CAUTIs) in clients requiring long-term indwelling catheters?

Perform catheter care twice a day.

While performing a respiratory assessment of a client with pneumonia, the nurse hears these sounds. Which assessment finding would the nurse document in the client's medical record? (sounds like a door creaking)

Pleural friction rubs

Which information would the nurse include in the discharge teaching plan for a client who sustained a cerebrovascular accident (CVA, also known as a "brain attack") with residual hemiparesis and hemianopsia?

Significance of a safe environment

Which precaution would the nurse identify as a prevention for transmission of human immunodeficiency virus (HIV) and other bloodborne illnesses?

Standard

In which order will the emergency department nurse take the prescribed actions for a client with hypoxemia and possible pneumonia?

The first action for a client who is hypoxemic is administration of oxygen. To have helpful culture results, any cultures must be obtained before antibiotic administration is started. The client will be admitted to the inpatient unit as quickly as possible, but the other actions would be done before admission. Antibiotic therapy would be started as quickly as possible once cultures were obtained.

Which describes the purpose of restricting sodium for a client with hypertension?

To prevent reabsorption of water in the distal tubules

The client is on neutropenic precautions. From which direction does the protective environment isolation help prevent the spread of infection?

To the client from outside sources

A client who sustained a significant reaction to the tuberculin skin test has negative findings on bacteriologic studies. X-ray findings and clinical evidence for tuberculosis (TB) were negative. Which class of TB would the nurse suspect?

class II

While providing care for four clients with human immunodeficiency virus (HIV) infections, the nurse notes newly developed clinical manifestations. Which client's condition would the nurse be able to delay reporting to the primary health care provider until unit rounds are made within the next 24 hours? A: burning, itching and discharge from the eyes B: blood in the urine C: yellow discoloration of the skin D: nausea and vomiting accompanied by abdominal pain

client A

The nurse would include which instruction to the parents of a child being treated with oral ampicillin for otitis media?

complete entire course of antibiotic therapy

An adolescent has been admitted with a history of symptoms of fatigue, intermittent fever, weight loss, and arthralgia, and the diagnosis is systemic lupus erythematosus. Which is the best intervention at this time?

education about diet, rest, and exercise

Which type of hypersensitivity reaction would the nurse teach a client with rheumatoid arthritis (RA)?

immune complex

In clients with human immunodeficiency virus (HIV), which potential complication is most important for the nurse to teach prevention strategies?

infection

The nurse understands which vaccine is administered through the intranasal route?

influenza live vaccine

A pregnant woman at risk of preterm labor is diagnosed with hypertension. For which medication would the nurse anticipate developing a teaching plan?

magnesium sulfate

A client is admitted to the hospital with a diagnosis of deep vein thrombosis, and intravenous (IV) heparin sodium is prescribed. If the client experiences excessive bleeding, which medication will the nurse be prepared to administer?

protamine sulfate

A primary health care provider diagnoses the client's condition as otitis media. Which assessment finding supports that diagnosis?

redness of the eardrum

According to the Centers for Disease Control and Prevention (CDC), which stage of the human immunodeficiency virus (HIV) disease is present in the client with a laboratory report revealing a CD4+ T-cell count of 520 cells/mm3?

stage 1

A client is experiencing an exacerbation of systemic lupus erythematosus. To reduce the frequency of exacerbations, what would be important for the nurse to include in the client's teaching plan?

techniques to reduce stress

Identify the type of hypersensitivity reaction associated with systemic lupus erythematosus (SLE).

type III

Which nursing intervention indicates misinformation when providing care for clients with the human immunodeficiency virus (HIV) infection?

"I will ask the client to avoid involvement in community activities."

A 30-year-old client who is diagnosed with hyperlipidemia and hypertension asks the nurse to explain why treatment is important, stating "I feel fine, so I don't really see the need to make any changes." Which response would the nurse make?

"Both high blood pressure and high cholesterol contribute to development of heart disease."

After the nurse has completed discharge teaching for a client who has had a myocardial infarction, which client statement indicates that more teaching is needed?

"I will avoid physical activity."

After a short hospitalization for an episode of a transient ischemic attack (TIA) related to hypertension, a client is discharged on a regimen that includes chlorothiazide. Which instruction will the nurse give the client regarding nutrition?

"Eat more dark green, leafy vegetables such as spinach."

Hydrochlorothiazide (HCTZ) has been prescribed for a client with hypertension. The client reports hearing that furosemide is more effective and requests a prescription change. How will the nurse respond?

"HCTZ has fewer side effects."

Which question would the nurse ask a client who has developed pneumonia when assessing risk factors?

"Are you diabetic?"

The nurse initiates rifampin for a client with tuberculosis. Which instructions would the nurse teach about this medication? Select all that apply. One, some, or all responses may be correct.

"Avoid drinking alcohol as long as you are on this medication." "Notify your provider immediately if you develop a yellow appearance to your skin." "Your soft contact lenses will become permanently stained because of this medication."

Which educational statements from the nurse will be beneficial for the client with tuberculosis? Select all that apply. One, some, or all responses may be correct.

"Avoid exposure to any inhalation irritants." "Eat foods that are rich in protein and vitamins C and B." "Cover the mouth and nose with a tissue when coughing or sneezing."

A client's cardiac monitor indicates ventricular tachycardia. The nurse assesses the client and identifies an increase in apical pulse rate from 100 to 150 beats/minute. Which action is indicated?

Administer amiodarone.

Which response by the nurse is bestwhen a client who has had an ST segment elevation myocardial infarction (STEMI) asks about the resumption of sexual activity?

"Sexual activities can be safely resumed after an exercise stress test with no heart symptoms."

Which action would the nurse take when a client receiving an infusion of penicillin reports having an anaphylactic reaction to penicillin in the past? Select all that apply. One, some, or all responses may be correct.

-notifying rapid response -measuring O2 level -administering epinephrine -inserting an indwelling catheter -assessing the respiratory pattern

When caring for an older client who has had multiple recent hospital admissions for heart failure, which action would the nurse take first?

Ask the client about medication use and activity level at home.

A client is admitted to the hospital with a diagnosis of pneumonia. In which order should the following nursing actions be accomplished?

1. obtain assessment info 2. collect a sputum sample for culture and sensitivity 3. administer prescribed antibiotic intravenous piggyback 4.check peak and trough levels of the antibiotic 5. review chest x-ray on an ongoing basis

A client with hypertension tells the nurse, "I took the blood pressure pills for a few weeks, but I didn't feel any different, so I decided I'd only take them when I feel sick." Which is the best action for the nurse to take?

Ask the client questions to determine the current understanding of high blood pressure.

A client who has atrial fibrillation with rapid ventricular response is started on a continuous heparin infusion. Which clinical finding enables the nurse to conclude that the heparin therapy is effective?

An activated partial thromboplastin time (aPTT) is twice the usual value.

Which finding in a client with a diagnosis of stable angina is most important for the nurse to communicate to the health care provider?

Angina episodes are occurring more frequently.

Which laboratory test would the nurse review for a client suspected to have rheumatoid arthritis?

Antinuclear antibody

When a client has sinus tachycardia, which potential causes of the dysrhythmia would the nurse consider when assessing the client? Select all that apply. One, some, or all responses may be correct.

Anxiety Caffeine Exercise Anemia

When providing care for a client with human immunodeficiency virus (HIV) infection, which clinical manifestation would the nurse report immediately to the primary health care provider?

Blood in the urine

Which nursing interventions promote safe administration of digoxin in a child diagnosed with heart failure? Select all that apply. One, some, or all responses may be correct.

Checking for compliance with the client's medication regimen Monitoring the client's serum potassium and magnesium levels regularly Calculating the correct dosage form, prescribed amounts, and the prescriber's prescription Monitoring and recording the client's intake and output, heart rate, blood pressure, daily weight, and respiration rate regularly

Which assessment would the nurse perform before administering a dose of vancomycin to a client? Select all that apply. One, some, or all responses may be correct.

Creatinine Trough level Hearing ability Intravenous site Blood urea nitrogen

Which assessment findings would the nurse identify in a client with clinical manifestations of rheumatoid arthritis (RA)? Select all that apply. One, some, or all responses may be correct.

Development of antinuclear antibodies Inflammatory disease pattern Bilateral involvement of metacarpophalangeal joints

Which intervention would the nurse perform to prevent disease transmission when caring for a hospitalized client with influenza?

Don a mask in the room.

Which nursing action will be most helpful in preventing transmission of influenza in crowded communities?

Educating about the importance of having annual vaccinations

After the nurse has completed teaching a client with hypertension about a heart-healthy diet, which meal choice by the client indicates that the teaching has been effective?

Grilled steak and green salad

Warfarin is prescribed for a client who has been receiving intravenous (IV) heparin for a partial occlusion of the left common carotid artery. The client expresses concern about why both medications are needed at the same time. Which rationale would the nurse include to address the client's concern?

Heparin provides anticoagulant effects until warfarin reaches therapeutic levels.

Which factor explains why a client who experiences an acute episode of rheumatoid arthritis has swollen finger joints?

Inflammation in the joint's synovial lining

Sublingual nitroglycerin has been prescribed for a client with unstable angina. Which client response indicates that nitroglycerin is effective?

Pain subsides as a result of arteriole and venous dilation.

When caring for a client with peripheral arterial insufficiency, how would the nurse position the client's feet and legs?

Place them slightly lower than the head and chest.

A client on antiretroviral therapy developed Pneumocystis jirovecipneumonia. Which nursing intervention is the priority for this client?

Providing adequate oxygenation for the client

When a client with angina is scheduled to have a cardiac catheterization, which explanation would the nurse give about the purpose of the procedure?

To visualize the disease process in the coronary arteries

For which clinical manifestations will the nurse monitor when caring for a client admitted with heart failure? Select all that apply. One, some, or all responses may be correct.

Unusual fatigue Dependent edema Nocturnal dyspnea

The laboratory report establishes that the client has a warfarin overdose. Which antidote would the nurse anticipate administering?

Vitamin K

A client's sputum smears for acid-fast bacilli (AFB) are positive and requires transmission-based airborne precautions. Which instruction would the nurse teach when orienting the client's visitors?

Wear a particulate respirator mask when in the room.

Which action would the nurse include in the plan of care for a client who had an ischemic stroke caused by atrial fibrillation and has been placed on anticoagulation therapy to prevent further strokes from occurring? Select all that apply. One, some, or all responses may be correct.

Wearing a medical alert bracelet Initiating bleeding precautions Refraining from estrogen therapy Obtaining routine prothrombin times Notifying providers of anticoagulation