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NURSING 207 Capstone Midterm Exam Questions
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Chapter 8-
Chapter 8
The nurse is caring for a client with heart failure, on assessment, the nurse notes that the client is dyspneic, and crackles are audible on auscultation. What additional manifestations would the nurse expect to note in this client if excess fluid volume is present? Ans: An increase in blood pressure and increased respirations The nurse reviews a client’s record and determines that the client is at risk for developing a potassium deficit if which situation is documented? Ans: Requires nasogastric suction The nurse reviews a client’s electrolyte laboratory report and notes that the potassium level is 2.5 mEq/L (2.5 mmol/L). Which patterns should the nurse watch for on the electrocardiogram (ECG) as a result of the laboratory value? SELECT ALL THAT APPLY Ans: U waves,
Inverted T waves, Depressed ST segment Potassium chloride intravenously is prescribed for a client with heart failure experiencing hypokalemia. Which actions should the nurse take to plan for preparation and administration of the potassium? SELECT ALL THAT APPLY Ans: Obtain an intravenous (IV) infusion pump, Monitor urine output during administration, Monitor the IV site for signs of infiltration and phlebitis, Ensure that the medication is diluted in the appropriate volume of fluid, Ensure that the bag is labeled so that it reads the volume of potassium in the solution.
suspects hyponatremia. What additional signs would the nurse expect to note in a client with hyponatremia? Ans: Hyperactive bowel sounds. The nurse reviews a client’s laboratory report and notes that the client’s serum phosphorus (phosphate) level is 1.8 mEq/dL (0.58 mmol/L). Which condition most likely cause this serum phosphate level? Ans: Malnutrition The nurse is reading a PHCP progress notes in the client’s record and reads that the PHCP has documented “insensible fluid loss of approximately 800 mL daily.” The nurse makes a notation that the insensible fluid loss occurs through which type of excretion? Ans: Integumentary output
The nurse is assigned to care for a group of clients. On review of the clients medical records, the nurse determines that which client is most likely at risk for a fluid volume deficit? Ans: A client with an ileostomy. The nurse is caring for a client who has been receiving intravenous (IV) diuretics suspects that the client is experiencing a fluid volume deficit. Which assessment finding would the nurse note in a client with this condition? Ans: Weight loss and poor skin turgor On review of the clients medical records, the nurse determines that which client is at risk for fluid volume excess? Ans: The client with kidney disease and a 12-year old history of diabetes mellitus Which client is at risk for the development of a potassium level of 5.5 mEq/L (5. mmol/L)? Ans: The client who has sustained a traumatic burn Chapter 9 The nurse reviews the ABG results of a client and notes the following: pH 7.45, PaCO2 of 30mm Hg, and HCO3- of 20 Meq/L (20mmol/L). The nurse analyzes these results as indicating which condition?
(ECG) monitor displays tachycardia, with a heat rate of 120 bpm. ABG are drawn and the nurse receives the results, expecting to note which finding? Ans: An increased pH and an increased HCO3- The nurse is caring for a client having respiratory distress related to an anxiety attack. Recent arterial blood gas values are pH=7.53, PaO2= 72mm Hg, PaCO2=32mm Hg, and HCO3-= 28mEq/L. Which conclusion about the client should the nurse make? Ans: The client is probably hyperventilating The nurse is caring for a client with diabetic ketoacidosis and documents that the client is experiencing Kussmaul’s respirations. Which patterns did the nurse observe? SELECT ALL THAT APPLY Ans: Respirations that are increased in rate, Respirations that are abnormally deep. A client who is found unresponsive has ABG drawn and the results indicate the following: pH 7.12, PaCO2 is 90 mm Hg, and HCO3- is 22 mEq/ L. The nurse interprets the results as indicating which condition? Ans: Respiratory acidosis, without compensation
The nurse notes that a client’s ABG results reveal a pH of 7.30 and a PaCO2 of 30 mmHg. The nurse monitors the client for which clinical manifestations associated with these ABG results? SELECT ALL THAT APPLY Ans: Nausea, Confusion, Tachycardia, lightheadedn ess The nurse reviews the blood gas results of a client with atelectasis. The nurse analyzes the results and determines that the client is experiencing respiratory acidosis. Which result validates the nurse’s findings? Ans: pH 7.25, PaCO2 50mm Hg
care for a client with chronic pain. Which statement, if made by the new graduate nurse, indicates the need for further teaching regarding pain management? Ans: I will be sure to cue into any indicators that the client may be exaggerating their pain. A client has been admitted to the hospital for gastroenteritis and dehydration. The nurse determines that the client has received adequate volume replacement if the blood urea nitrogen (BUN) level drops to which value? Ans: 15mg/dL (5.4 mmol/L)
The nurse is explaining the appropriate methods for measuring an accurate temperature to an assistive personnel (AP). Which method, if noted by the UAP as being an appropriate method, indicates the need for further teaching? Ans: Taking an ora temperature for a client with a cough and nasal congestion. A client is receiving a continuous intravenous infusion of heparin sodium to treat deep vein thrombosis. The client’s activated partial thromboplastin time (aPTT) is 65 seconds. The nurse anticipates that which action is needed? Ans: Leaving the rate of the heparin as is. A client with a history of heart failure is due for a morning dose of furosemide. Which serum potassium level, if noted int eh client’s laboratory report, should be reported before administering the dose of furosemide? Ans: 3.2 mEq/L (3.2 mmol/L) Several laboratory tests are prescribed for a client, and the nurses reviews the results of the tests. Which laboratory tests results should the nurse report? SELECT ALL THAT APPLY Ans: Platelets 35,000 mm, Sodium 150 mEq/L, Segmented neutrophils 40%, White blood cells,
The nurse is caring for a client with a diagnosis of breast cancer who is immunosuppressed. The nurse would consider implementing neutropenic precautions if the client WBC count was which value? Ans: 2000 mm A client brought to the ED states that he has accidentally been taking 2 times his prescribed dose of warfarin for the past week. After noting that the client has no evidence of obvious bleeding, the nurse plans to take which action? Ans: Draw a sample for prothrombin Time (PT) and international normalized ratio (INR). The nurse is caring for a postoperative client who is receiving demand-dose hydromorphone via a patient-controlled analgesia (PCA) pump for pain control. The nurse enters the client’s room and finds the client drowsy and records the following vital signs: Temperature 97.2F (36.2C) orally, pulse 52 bpm, BP 101/58mm Hg, respiratory rate 11 breaths per minute, and SpO2 of 93% on 3 liters of O2 via nasal cannula. Which action should the nurse take next? Ans: Attempt to arouse the client An adult female client has a hemoglobin level of 10.8g/dL (108 mmol/L). The nurse interprets that this result is most likely cause by which condition noted in the client’s history? Ans: Iron defiency anemia
A client with a history of upper gastrointestinal bleeding has a platelet count of 300,000mm. The nurse should take which action after seeing the laboratory result? Ans: Place the normal report in the clients medical record Chapter 11 The nurse is teaching a client who has iron defiecincy anemia bout foods she should include in the diet. The nurse determines that the client understands the dietary modifications if which items are selected from the menu? Ans: Oranges and dark green leafy vegetables
The nurse is instructing a client with hypertension on the importance of choosing foods low in sodium. The nurse should teach the client to limit intake of which food? Ans: Smoked Salami A client who is recovering from surgery has been advanced from a clear liquid diet to a full liquid diet. The client is looking forward to the diet change because he has been “bored” with eh clear liquid diet. The nurse should offer which full liquid item to the client? Ans: Custard A client is recovering from abdominal wound. The nurse should encourage the client to eat which food item that is naturally high in vitamin C to promote wound healing? Ans: Oranges
The nurse is caring for a client with cirrhosis of the liver. To minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has the best understanding of the dietary measures to follow of the client states an intention to increase the intake of which food? Ans: Legumes The nurse provides instructions to a client with a low potassium level about the foods that are high in potassium and tells the client to consume which foods? SELECT ALL THAT APPLY Ans: Raisins, potatoes, cantaloupe, strawberrie s The nurse is reviewing laboratory results and notes that a client’s serum sodium level is 150 mEq/L. The nurse reports the serum sodium level to the PHCP, and the PHCP prescribes dietary instructions based on the sodium level. Which acceptable food items does the nurse instruct the client to consume? SELECT ALL THAT APPLY Ans: Peas
The nurse is performing a neurological assessment on a client and notes a positive Romberg’s test. The nurse makes this determination based on which observation? Ans: A significant sway when the client stands erect with feet together, arms at the side, and the eyes are closed The nurse notes doci=umentation that a client is exhibiting Cheyne-stokes respirations. On assessment of the client, the nurse should expect to note which finding? Ans: Rythmic respirations with periods of Apnea A client diagnosed with conductive hearing loss asks the nurse to explain the cause of the hearing problem. The nurse plans to explain to the client that this condition is caused by which problem? Ans: A physical obstruction to the transmission of sound waves. While performing a cardiac assessment on a client with an incompetent heart valve, the nurse auscultates a murmur. The nurse documents the finding and documents the findings and describes the sound as which? Ans: A blowing or swooshing sound The nurse is testing the extraocular movements in a client to assess for muscle weakness in the eyes. The nurse implement which assessment technique to assess
for muscle weakness In the eye? Ans: Test the 6 cardinal positions of gaze. The nurse Is instructing a client on how to perform a testicular self-examination (TSE). The nurse should explain that which is the best time to perform this exam? Ans. After a shower or bath The nurse is assessing a client suspected of having meningitis for meningeal irritation and elicits s positive Brudzinki’s sign. Which finding did the nurse observe? Ans: The client passively flexes the hip and knee in response to neck flexion and reports pain in the vertebral column.
