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NURSING FINAL EXAM QUESTIONS AND ANSWERS, 2023
Question 1 of 60 A nurse is osculating a client’s lung sounds and identifies crackles in the left lobe. Which of the following interventions should the nurse take? a. Repeat auscultation after asking the client to breathe deeply and cough b. Prepare to administer antibiotics. c. Place the client on bed rest in semi-Fowler's position d. instruct the client to limit fluid intake to less than 2,000 mL/day Answer: a Question 2 of 60 A nurse is assessing for cyanosis client who has dark skin. Which of the following sites should the nurse examine to identify cyanosis in this client? a. Dorsal surface of the hand b. Pinnae of the ears c. Conjunctivae d. Dorsal surface of the foot Answer: c Question 3 of 60 A nurse is assessing a client who has a fracture of the femur. The nurse obtains vital signs on admission and again in 2 hours. Which
of the following changes in assessment should indicate to the nurse that the client could be developing a serious complication? a. Increased blood pressure from 112/68 to 120/72 mm Hg. b. Increased oral temperature from 36.6* C (97,8* F) to 37* C (98.6* F) c. Increased heart rate from 68 to 72/min d. increased respiratory rate from 18 to 44/m Answer: d Question 4 of 60 A nurse is assessing a client who has chronic respiratory Insufficiency. Which of the following findings should the nurse expect as result of the long-term inadequate oxygenation? a. Retractions b. Restlessness c. Dependent edema d. Clubbing of the fingers Answer: d Question 5 of 60 A nurse in a provider's office is assessing a client. The nurse should identify that which of the following findings are manifestations of pulmonary tuberculosis? (Select all that apply). a. Blood in the sputum b. Night sweats c. Flushed cheeks d. Weight gain e. Low-grade fever
b. Initiating oxygen therapy c. Administering a nebulized beta-adrenergic d. Positioning the client in high-Fowler’s Answer: c Question 9 of 60 A nurse is preparing to provide tracheostomy care for a client who has a nondisposable tracheostomy tube. Which of the following equipment should the nurse plan to use? (Select all that apply.) a. Clean gloves b. Sterile water c. Sterile basin d. Sterile cotton balls e. Sterile cotton-tipped applicators Answer: Question 10 of 60 A nurse is receiving shift report about a group of assigned clients. Which of the following actions should the nurse plan to take first? a. Suction the tracheostomy of a client who has copious secretions. b. Reinsert an intravenous catheter that was removed due to nitration. c. Ask the provider about advancing a client's diet. d. Check the laboratory findings of a preoperative client scheduled for surgery later in the shift. Answer: a
Question 11 of 60 A nurse is assessing a client who is 1 day postoperative following a lobectomy and has a chest tube drainage system in place. Which of the following findings by the nurse indicates a need for intervention? a. Chest tube eyelets not visible b. Development of subcutaneous emphygena c. Presence of tidal fluctuation in the water seal chamber d. Continuous bubbling in the suction control chamber Answer: b Question 12 of 60 A nurse is providing discharge instructions to a client who has asthma and is about to start taking theophylline (Theo-24). The nurse should tell client that this medication might cause which of the following adverse effects? a. Tachycardia b. Oliguria c. Constipation d. Drowsiness Answer: a Question 13 of 60 A home health nurse visits a client who has COPD and receives oxygen at 2 L/min via nasal cannula. The client reports difficulty breathing. Which of the following actions is the nurse's priority? a. Increase the oxygen flow to 3 L/min.
Answer: a Question 16 of 60 A nurse Is caring for a client who Is taking montelukast. Which of the following outcomes Indicates a therapeutic effect of the medication? a. The client experiences an increased ease of breathing. b. The client's seizure threshold is reduced. c. The client's platelet count is increased. d. The client experiences less muscle pain. Answer: a Question 17 of 60 nurse is performing chest physiotherapy on a client who has a respiratory infection. To Increase the velocity and turbulence of the air the client exhales, which of the following techniques should the nurse use? a. vibration b. Postural drainage c. Percussion d. Nebulization Answer: a Question 18 of 60 A nurse is providing discharge instructions to a client who has asthma and a new prescription for montelukast. The nurse should instruct the client to report which of the following adverse effects to the provider?
a. Constipation b. Blurred vision c. Depression d. Palpitations Answer: c Question 19 of 60 A nurse is teaching a client about taking diphenhydramine. The nurse should explain to the client that which of the following is an adverse effect of this medication? a. Hypertension b. Constipation c. Bradycardia. d. Sedation Answer: d Question 20 of 60 A nurse Is admitting a client who has active tuberculosis to a room on a medical-surgical unit. Which of the following room assignments nurse make for the client? a. A room with air exhaust directly to the outdoor environment b. A room in the ICU c. A room with another nonsurgical client d. A room that is within view of the nurses' station Answer: a Question 21 of 60
Question 24 of 60 A nurse on a medical-surgical unit is performing an admission assessment of a client who has COPD with emphysema. The client reports that he has a frequent productive cough and is short of breath. The nurse should anticipate which of the following assessment findings for this client? a. Oxygen saturation level 96% b. Petechiae on chest c. Increased anteroposterior diameter of the chest d. Respiratory alkalosis Answer: c Question 25 of 60 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 a. Hemodynamic status b. Renal function c. Intracranial pressure d. Spinal cord perfusion Answer: a Question 26 of 60 A nurse is caring for a client who is receiving oxygen at 2 L/min via a nasal cannula. The nurse recognizes the client is receiving which of the following inspired oxygen concentration?
a. 28% b. 36% c. 50% d. 70% Answer: a Question 27 of 60 A nurse is caring for a group of clients in an infectious disease unit. The nurse should wear an OSHA-approved N95 respirator mask when caring for a client with which of the following infectious diseases? a. Tuberculosis b. Pertussis c. Mycoplasma pneumonia d. Respiratory syncytial virus Answer: a Question 28 of 60 A nurse is caring for a child who Is experiencing status asthmaticus. Which of the following interventions is the priority for the nurse to take? a. Administer a short-acting B2 -agonist (SABA). b. Determine the cause of the acute exacerbation. c. Obtain a peak flow reading. d. Administer an inhaled glucocorticoid. Answer: a
d. Suppresses the urge to cough Answer: b Question 32 of 60 Question 33 of 60 Question 34 of 60 Question 35 of 60 Question 36 of 60 A nurse is providing discharge teaching to a client who has asthma and a new prescription for fluticasone/salmeterol. For which of the following adverse effects should the nurse instruct the client a. Dry oral mucous membranes b. Sedation c. White coating in the mouth d. Increased appetite Answer: c Question 37 of 60 A nurse is caring for a client who has emphysema. Which of the following findings should the nurse expect to assess in this client? (Select all that apply).
a. Barrel chest b. Dyspnea c. Clubbing of the fingers d. Bradycardia e. Deep respirations Answer: a, b, and c. Question 38 of 60 A nurse is teaching a client who has asthma how to use a metered- dose inhaler (MDI). The nurse identifies the sequence of steps the client should follow. (Move the steps into the box on the right, placing them in the selected order of performance. Use all steps).
- Exhale slowly through pursed lips.
- Walt 60 seconds between each puff
- Breathe in deeply over 2 to 3 seconds while pushing down on the
- inhale deeply and then exhale completer
- Place her lips firmly around the mouthpiece
- Hold her breath for 10 seconds. Answer: 4, 5, 3, 6, 1, 2. Question 39 of 60 A nurse is dining at a restaurant when a woman begins to scream that her partner is choking. Which of the following actions should the nurse take? a. Instruct the woman to call 911 b. Ask the partner if he can speak. c. Perform chest compressions. d. Use the jaw-thrust maneuver.
action plan. The nurse should base her actions on which of the following information? (Select all that apply.) a. The nurse should obtain a second expiratory flow rate. b. The student needs to go to the hospital. c. The student's peak flow is 50% to 80% of his best peak flow d. The student's asthma is not well controlled. e. The student should use his quick-relief inhaler Answer: a, c, d, and e. Question 43 of 60 A nurse is caring for a client who has just developed a pulmonary embolism. Which of the following medications should the nurse an administering? a. Atropine b. Furosemide c. Heparin d. Dexamethasone Answer: c Question 44 of 60 A nurse is caring for a client who has pneumonia and a prescription for oxygen therapy at 5 L/min via nasal cannula. Which of the following actions should the nurse take? a. Remove the nasal cannula while the client eats b. Attach a humidifier bottle to the base of the flow meter. c. Apply petroleum jelly to the nares as needed to soothe mucous membranes.
d. Secure the oxygen tubing to the bed sheet near the client's head. Answer: b Question 45 of 60 A nurse is prioritizing client care after receiving change-of-shift report. Which of the following clients should the nurse plan to see first? a. A client who told an assistive personnel he is short of breath b. A client who received oral pain medication 30 min ago c. A client who Is scheduled for an abdominal x-ray and is awaiting transport d. A client who has a prescription for discharge Answer: a Question 46 of 60 A nurse in the emergency department is caring for a client who has extensive partial and full-thickness burns of the head, neck, and chest. While planning the client's care, the nurse should identify which of the following risks as the priority for assessment and intervention? a. Infection b. Airway obstruction c. Fluid imbalance d. Paralytic ileus Answer: b
c. “Breathing in carbon monoxide can cause headaches and nausea.” d. “ I can detect the presence of carbon monoxide by a metallic odor.” Answer: d Question 50 of 60 A nurse is caring for a client who is immobile. Which of the following actions is the priority for the nurse to include in the client's plan of care? a. Perform range-of-motion (ROM) exercises at least two to three times daily b. Make sure the client has an Intake of 2,000 to 3,000 mL of fluid per day c. Auscultate breath sounds at least every 2 hr. d. Apply antiembolic stockings. Answer: c Question 51 of 60 A nurse Is conducting a primary survey of a client who has sustained life-threatening injuries due to a motor-vehicle crash. Identify the sequence of actions the nurse should take. (Move the actions into the box on the right, placing them in the selected order of performance. Use all the steps.) a. Remove clothing for a thorough assessment. b. Establish IV access. c. Open the airway using a jaw-thrust maneuver. d. Perform a Glasgow Coma Scale assessment.
e. Determine effectiveness of ventilator efforts. Answer: c, e, b, d, and a. Question 52 of 60 A nurse in an emergency room is caring a the client who sustained partial-thickness burns to both lower legs, chest, face, and both forearms. Which of the following is the priority action the nurse should take? a. Draw blood for a complete blood cell (CBC) count. b. Inspect the mouth for signs of inhalation injuries. c. Insert an indwelling urinary catheter. d. Administer intravenous pain medication. Answer: b Question 53 of 60 The nurse is caring for a postoperative client who has a chest tube connected to suction and a water seal drainage system. Which of the following indicates to the nurse that the chest tube is functioning properly? a. Fluctuation of the fluid level within the water seal chamber b. Absence of fluid in the drainage tubing c. Equal amounts of fluid drainage in each collection chamber d. Continuous bubbling within the water seal chamber Answer: a Question 54 of 60
