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A client has received 10 mg of morphine sulfate subcutaneously. When does the nurse anticipate the maximal period of respiratory depression will occur?
How many hours of activity per day are necessary to prevent disuse syndrome with muscle atrophy and joint contracture?
The nurse is one of the first on the scene of a bus accident and is triaging injured riders. Place the following injured clients into the correct triage classification.
I. 40-year-old woman with arterial bleeding
II. 20-year-old male with a sprained wrist, small cuts, and bruises
III. 14-year-old female with severe crush injuries to the head and chest and dilated, non-responsive pupils
IV. 56-year-old male with a fractured femur
Minor injury (Ambulatory injured) | Immediate care | Delayed care | Unsalvageable |
1. ______ | 2. ______ | 3. ______ | 4. ______ |
Which injured client is placed into the triage classification Minor injury (Ambulatory injured)
The nurse is one of the first on the scene of a bus accident and is triaging injured riders. Place the following injured clients into the correct triage classification.
I. 40-year-old woman with arterial bleeding
II. 20-year-old male with a sprained wrist, small cuts, and bruises
III. 14-year-old female with severe crush injuries to the head and chest and dilated, non-responsive pupils
IV. 56-year-old male with a fractured femur
Minor injury (Ambulatory injured) | Immediate care | Delayed care | Unsalvageable |
1. ______ | 2. ______ | 3. ______ | 4. ______ |
Which injured client is placed into the triage classification Immediate care
The nurse is one of the first on the scene of a bus accident and is triaging injured riders. Place the following injured clients into the correct triage classification.
I. 40-year-old woman with arterial bleeding
II. 20-year-old male with a sprained wrist, small cuts, and bruises
III. 14-year-old female with severe crush injuries to the head and chest and dilated, non-responsive pupils
IV. 56-year-old male with a fractured femur
Minor injury (Ambulatory injured) | Immediate care | Delayed care | Unsalvageable |
1. ______ | 2. ______ | 3. ______ | 4. ______ |
Which injured client is placed into the triage classification Delayed care
The nurse is one of the first on the scene of a bus accident and is triaging injured riders. Place the following injured clients into the correct triage classification.
I. 40-year-old woman with arterial bleeding
II. 20-year-old male with a sprained wrist, small cuts, and bruises
III. 14-year-old female with severe crush injuries to the head and chest and dilated, non-responsive pupils
IV. 56-year-old male with a fractured femur
Minor injury (Ambulatory injured) | Immediate care | Delayed care | Unsalvageable |
1. ______ | 2. ______ | 3. ______ | 4. ______ |
Which injured client is placed into the triage classification Unsalvageable
A client nearing death has an advance directive in his records indicating that he does not want intravenous fluids or other invasive procedures, but the client’s physician has ordered IV fluids. Which of the following initial actions by the nurse is most appropriate?
A client has been instructed in the application and use of anti-embolic compression stockings. Which of the following statements by the client indicates a need for more teaching? Select all that apply.
A client with a demand pacemaker complains that he has developed persistent chronic hiccupping and is experiencing mild discomfort in the chest. Which of the following causes does the nurse suspect?
Which of the following common neurological changes is/are NOT associated with aging? Select all that apply.
When examining an 80-year-old client with COPD receiving home health care, the nurse notes that over the previous 48 hours the client has developed scattered painful pustular lesions on the right arm near the elbow (see photo), the back of the neck, the face, and on both legs.
Which of the following does the nurse suspect is the most likely cause of the lesions?
A Turkish-speaking client is scheduled for a colonoscopy, and the nurse must provide printed directions to the client, but directions are not available in Turkish. Which of the following is most appropriate?
While a dosage of oral morphine has approximately 25% bioavailability, what percentage is the bioavailability of an intravenous dose of morphine? Record your answer as a whole number.
__________ %
The nurse is teaching the mother of a newborn to care for the umbilical cord. What should the nurse advise the mother to do if the cord becomes soiled with urine or feces?
A client is in acute postoperative pain, and the physician orders 85 mg of meperidine (Demerol®) stat. The vial contains 100 mg in 2 mL. How many milliliters should the nurse administer? Record your answer as a decimal number.
__________ mL
The physician has ordered that a client recovering from back surgery be logrolled. The client has a draw sheet in place, and the nurse and an assistant are positioned with one on each side of the bed.
What is the first step to logrolling?
The physician has ordered that a client recovering from back surgery be logrolled. The client has a draw sheet in place, and the nurse and an assistant are positioned with one on each side of the bed.
What is the second step to logrolling?
The physician has ordered that a client recovering from back surgery be logrolled. The client has a draw sheet in place, and the nurse and an assistant are positioned with one on each side of the bed.
What is the third step to logrolling?
The physician has ordered that a client recovering from back surgery be logrolled. The client has a draw sheet in place, and the nurse and an assistant are positioned with one on each side of the bed.
What is the fourth step to logrolling?
The physician has ordered that a 132-pound client with increased intracranial pressure receive 0.5 g of mannitol per kg in an IV solution. How many grams should be in the total mannitol dose? Record your answer as a whole number.
__________ g
When applying the leads for a 12-lead electrocardiogram, the nurse places V1 and V2 at the fourth intercostal space to the right and left of the sternum. Which of the remaining leads is placed at the fifth intercostal space on the left midclavicular line?
A client is recovering from a stroke and the nurse is doing range-of-motion exercises. Which movements should be included for ROM of the elbow on the weak side? Select all that apply.
The nurse is assisting a client to adjust crutches to the proper measurement. With the client in standing position, where should the tips of the crutches be placed?
A client who is very confused removed a diamond ring and threw it on the floor. Which of the following is the most appropriate action?
If the first day of a pregnant woman’s last menstrual period fell on May 1, 2013, what is the expected delivery month and year?
Twenty micrograms (mcg) are equal to how many milligrams? Record your answer as a decimal number.
__________ mg
A physician orders chest physiotherapy for a 4-year-old child with cystic fibrosis, but the respiratory therapists are off duty, so the physician tells the nurse to do the therapy. The nurse, however, rarely works in pediatrics, has never done chest physiotherapy, and does not know the procedure. Which of the following is the most appropriate response by the nurse?
A pregnant woman has experienced repeated vaginal monilial infections. When educating the client about the infection, which information should the nurse include? Select all that apply.
When drawing up a dosage of subcutaneous heparin, how much air should be drawn into the syringe after the correct dosage is obtained?
Lochia serosa usually is evident on days 4–10 postpartum. When teaching the client about postpartum care, how should the nurse describe lochia serosa?
The Z-track injection technique should be used with which of the following? Select all that apply.
A Mexican-American client states that she and her family live next door to her brother and his family and that they share goods, services, and childcare. How is this type of family classified?
The physician has ordered sublingual nitroglycerin for a client. Which of the following are contraindications for administration of sublingual or buccal medications? Select all that apply.
The nurse is teaching a new breastfeeding mother about breast care, but the mother has engorgement and asks if she should quit breastfeeding. Which information should the nurse include? Select all that apply.
When administering a capsule that is individually wrapped to a client, when should the wrapping be removed?
Which of the following are important factors in facilitating attachment between a newborn and mother?
Which of the following are controlled substances (Schedules I through V) regulated by the Drug Enforcement Agency (DEA)? Select all that apply.
Which of the following ethnic groups has the highest risk of developing diabetes mellitus type 2 and should be routinely screened for diabetes?
A hospice client is receiving high doses of opioid analgesia and is exhibiting nocturnal myoclonus with restless leg movement and involuntary jerking. Which of the following responses should the nurse expect?
A 16-year-old female has been sexually active for two years but was recently treated for a gonorrhea infection. The nurse is teaching the adolescent about safe sex practices. Which of the following statements by the adolescent indicate a need for more information? Select all that apply.
A client receiving high doses of hydromorphone (Dilaudid®) develops acute respiratory depression with a drop in blood pressure. Which of the following treatments is most indicated?
A 20-year-old client has taken forty 500-mg tablets of acetaminophen with 4 ounces of alcohol in a suicide attempt. The client is most at risk for which of the following?
A client with bipolar disorder is taking lithium to control symptoms. Which of the following statements indicates the need for further education?
Which of the following antibiotics is contraindicated in children younger than 8 years?
A nurse notes that clients of one surgeon have developed at least twice as many infections as clients of other surgeons on the unit. Which of the following is the most appropriate action?
Which type of laxative agent is usually the safest for most people?
The practical nurse is assisting the respiratory therapist in obtaining a blood gas. Prior to drawing blood for blood gas analysis, the respiratory therapist conducts the modified Allen test to ensure there is adequate collateral circulation. The respiratory therapist asks the client to extend her wrist over a rolled towel and make a fist.
What is the first step?
The practical nurse is assisting the respiratory therapist in obtaining a blood gas. Prior to drawing blood for blood gas analysis, the respiratory therapist conducts the modified Allen test to ensure there is adequate collateral circulation. The respiratory therapist asks the client to extend her wrist over a rolled towel and make a fist.
What is the second step?
The practical nurse is assisting the respiratory therapist in obtaining a blood gas. Prior to drawing blood for blood gas analysis, the respiratory therapist conducts the modified Allen test to ensure there is adequate collateral circulation. The respiratory therapist asks the client to extend her wrist over a rolled towel and make a fist.
What is the third step?
The practical nurse is assisting the respiratory therapist in obtaining a blood gas. Prior to drawing blood for blood gas analysis, the respiratory therapist conducts the modified Allen test to ensure there is adequate collateral circulation. The respiratory therapist asks the client to extend her wrist over a rolled towel and make a fist.
What is the fourth step?
What is the critical point for \(\mathbf{PO}_{2}\) (the “ICU point”), or the percentage point at which there is marked decrease in oxygen saturation? Record your answer as a whole number.
__________ %
A client with heart failure has been prescribed the DASH diet (dietary approaches to stop hypertension) and must limit sodium intake to 2,300 mg per day. Which of the following statements by the client indicates a need for further education?
A client has immune thrombocytopenic purpura. The client’s platelet count is 19,000. Which initial treatment should the nurse expect?
A client is being assessed for neutropenia. The client’s total white blood cell count is 5,200 with 45% neutrophils and 5% bands. What is the absolute neutrophil count (ANC)? Record your answer as a whole number.
__________
Each staff person has an individual password that allows access to electronic health records. Under which of the following circumstances should a nurse allow another staff person to use his or her password?
The nurse is part of an interdisciplinary team in a rehabilitation unit. Which of the following statements by a client is most important to be communicated to the social worker on the team?
An 84-year-old female with COPD in an extended-care facility is alert and responsive and has been maintained on low-flow oxygen and nebulizer treatments. However, the client, who is bedridden, has removed the oxygen and refused nebulizer treatments, telling the nurse that she is ready to die and only wants comfort measures. Which of the following actions by the nurse is most appropriate?
If a client’s LDL cholesterol is 100, HDL cholesterol is 50, and triglycerides are 150, what is the client’s total cholesterol? Record your answer as a whole number.
__________
Nutrients per serving:
Nutrients | Lunch meat | Peanuts | Cheese | Apple |
Fat | 6 grams | 14 grams | 9 grams | 0.3 grams |
Carbs | 1 gram | 5 grams | 1 gram | 25 grams |
Insol. Fiber | 0 grams | 1 gram | 0 | 5 grams |
Protein | 7 grams | 7 grams | 7 grams | 0.5 grams |
Which of the snacks—lunch meat, peanuts, cheese, or apple—has the lowest number of calories per serving?
The nurse is conducting an examination of the abdomen and auscultating for bruits. Label the lettered points on the diagram identifying the position of the arteries.
What artery is positioned at lettered point A?
The nurse is conducting an examination of the abdomen and auscultating for bruits. Label the lettered points on the diagram identifying the position of the arteries.
What artery is positioned at lettered point B?
The nurse is conducting an examination of the abdomen and auscultating for bruits. Label the lettered points on the diagram identifying the position of the arteries.
What artery is positioned at lettered point C?
The nurse is conducting an examination of the abdomen and auscultating for bruits. Label the lettered points on the diagram identifying the position of the arteries.
What artery is positioned at lettered point D?
A female client is scheduled for a routine pelvic exam. Which of the following should the nurse ask the client to do prior to the exam?
The nurse is inserting an intravenous line into the right arm and has identified a potential insertion site. Place the steps (indicated in Roman numerals) of venipuncture in the proper sequential order.
I. Palpate vein.
II. Cleanse skin.
III. Apply tourniquet.
IV. Perform venipuncture.
What is the first step of venipuncture?
The nurse is inserting an intravenous line into the right arm and has identified a potential insertion site. Place the steps (indicated in Roman numerals) of venipuncture in the proper sequential order.
I. Palpate vein.
II. Cleanse skin.
III. Apply tourniquet.
IV. Perform venipuncture.
What is the second step of venipuncture?
The nurse is inserting an intravenous line into the right arm and has identified a potential insertion site. Place the steps (indicated in Roman numerals) of venipuncture in the proper sequential order.
I. Palpate vein.
II. Cleanse skin.
III. Apply tourniquet.
IV. Perform venipuncture.
What is the third step of venipuncture?
The nurse is inserting an intravenous line into the right arm and has identified a potential insertion site. Place the steps (indicated in Roman numerals) of venipuncture in the proper sequential order.
I. Palpate vein.
II. Cleanse skin.
III. Apply tourniquet.
IV. Perform venipuncture.
What is the fourth step of venipuncture?
A client is receiving oxygen per nasal cannula at 3 L/minute. Which of the following is the approximate inspired oxygen concentration (FiO2)?
A client is taking nebulizer treatments for asthma, and the nurse is instructing the client in the correct method for measuring peak expiratory flow rates (PEFR) after treatment. The nurse prepares the meter with the indicator at the base of the scale. Place the following steps (Roman numerals) in the correct order from first to last.
I. Client sits upright or stands.
II. Client places the meter in the mouth and seals lips.
III. Client expels air through the meter as forcefully as possible.
IV. Client takes a deep breath.
What is the first step?
A client is taking nebulizer treatments for asthma, and the nurse is instructing the client in the correct method for measuring peak expiratory flow rates (PEFR) after treatment. The nurse prepares the meter with the indicator at the base of the scale. Place the following steps (Roman numerals) in the correct order from first to last.
I. Client sits upright or stands.
II. Client places the meter in the mouth and seals lips.
III. Client expels air through the meter as forcefully as possible.
IV. Client takes a deep breath.
What is the second step?
A client is taking nebulizer treatments for asthma, and the nurse is instructing the client in the correct method for measuring peak expiratory flow rates (PEFR) after treatment. The nurse prepares the meter with the indicator at the base of the scale. Place the following steps (Roman numerals) in the correct order from first to last.
I. Client sits upright or stands.
II. Client places the meter in the mouth and seals lips.
III. Client expels air through the meter as forcefully as possible.
IV. Client takes a deep breath.
What is the third step?
A client is taking nebulizer treatments for asthma, and the nurse is instructing the client in the correct method for measuring peak expiratory flow rates (PEFR) after treatment. The nurse prepares the meter with the indicator at the base of the scale. Place the following steps (Roman numerals) in the correct order from first to last.
I. Client sits upright or stands.
II. Client places the meter in the mouth and seals lips.
III. Client expels air through the meter as forcefully as possible.
IV. Client takes a deep breath.
What is the fourth step?
Following application of a right BK prosthesis for an amputated limb, the client returns for evaluation, and the nurse notes that the client has an unstable gait and the right hip and knee are showing signs of slight flexion contractures. The client admits to infrequent use of the prosthesis. Which of the following interventions are most indicated? Select all that apply.
The nurse is assisting a client who is to undergo a thoracentesis. Which of the following is the optimal position for the procedure?
A client has experienced 48 hours of severe repeated bouts of vomiting. Which acid-base imbalance is of most concern?
A client is scheduled for hemodialysis twice weekly through an arteriovenous fistula in the left arm. Following each hemodialysis treatment, the nurse should evaluate the client for which of the following because of risks associated with hemodialysis? Select all that apply.
A client with liver failure and ascites is having a paracentesis to relieve severe dyspnea resulting from abdominal fluid accumulation. Prior to the procedure, the nurse assists the client to urinate. Which of the following is the most important reason to have the patient urinate?
Which of the following diseases must be reported to the CDC? Select all that apply.
A 72-year-old client with Parkinson’s disease is recovering from pneumonia and is to be discharged, but he remains weak and has poor control of his hands because of tremors. A home health aide will visit three times weekly to assist the client with bathing, and his daughter will visit every evening after work to help with laundry and housework. Which of the following referrals is most indicated to allow the client to remain independent in his home?
A client is receiving hospice and palliative care, including analgesia and other comfort measures. Which of the following indicates the client is undergoing life review? Select all that apply.
A mother brings her child to the clinic because of repeated bouts of head lice. Which of the following statements by the mother suggests a need for education? Select all that apply.
A client states that she is severely allergic to avocados, kiwi fruit, and bananas. The nurse should suspect that the client may also be allergic to:
A client has been on prolonged bedrest following surgery. The nurse notes that the patient has pain in the right calf on palpation with dorsiflexion of the ankle. Which of the following causes does the nurse suspect?
A client had a craniotomy for a basal meningioma and is being monitored postoperatively. The client’s baseline blood pressure and pulse were BP 138/72 and P 82. Temperature was 97.5 °F/36.4 °C. The client is awake and responding. Which of the following findings most indicates possible increasing intracranial pressure?
A client is being discharged with an implantable cardioverter-defibrillator (ICD), and the nurse is educating the client about home management. The client asks what he should do if the ICD fires one time but he has no other symptoms. Which of the following is the best advice?
When assessing a client for risk of falls, the nurse should be aware that the primary risk factors include which of the following? Select all that apply.
A client is to be discharged on warfarin (Coumadin®) therapy, and the nurse is teaching the client about the medication. Which of the following statements by the client indicates that the client’s education has been effective? Select all that apply.
A 10-year-old client is scheduled for surgery, and the hospital allows parents to be with the child during anesthesia induction. The nurse assists the child’s mother to gown and explains the parent’s role during induction, but the mother begins to cry when she prepares to enter to operating room. Which of the following is the most appropriate response?
A client was to receive 1 g of vancomycin intravenously in 200 mL of iso-osmotic solution over 60 minutes per infusion pump. However, the IV administration was discontinued after 45 minutes because the client developed nausea and chills. How many milligrams of vancomycin did the client receive? Record your answer as a whole number.
__________ mg
If a client’s waist measurement is 38 inches and the hip measurement is 45 inches, what is the client’s waist-to-hip ratio. Round your answer to two decimal places.
__________
The nurse is monitoring a client following postoperative cardiac catheterization and is checking the client’s oxygen saturation (SPO2) per pulse oximetry. The nurse recognizes that the SPO2 should be maintained above what percentage in most clients to ensure adequate oxygenation? Record your answer as a whole number.
__________ %
An older adult has become very confused after surgery for repair of a hip fracture. The client has repeatedly tried to climb over the bedrails, and the nurse is considering placing the client in a Posey vest that is secured to the bed. Which of the following must the nurse consider when applying restraints to a client? Select all that apply.
The nurse is working with mothers and newborns. When educating a new mother about security measures to protect her infant, which of the following should the nurse include?
The nurse must administer 120 mg of amoxicillin oral suspension to a child. However, the only dosage available in the pharmacy is 200 mg per 5 mL. How many milliliters of suspension should the nurse administer? Record your answer as a whole number only.
__________ mL
Based on clinical findings, the physician suspects that a 65-year-old client has kidney disease and has ordered a blood urea nitrogen (BUN) test. Which of the following results is within normal limits?
If a group includes only members selected on a specific basis, such as women with a history of domestic or partner abuse, how is this type of group classified?
A client with an artificial eye is too ill to remove the eye, but the lids are crusted and irritated, so the nurse must remove the prosthesis for cleaning and to inspect the eye socket. The nurse has washed hands and applied disposable gloves. What is the correct order of the remaining steps to removing the prosthesis?
I. Gently retract the upper lid.
II. Exert slight pressure below the eyelid and slip the index finger under the prosthesis.
III. Break suction and slide the prosthesis out of the eye.
IV. Gently retract the lower eyelid against the orbital ridge with the thumb.
What is the first step to removing the prosthesis?
A client with an artificial eye is too ill to remove the eye, but the lids are crusted and irritated, so the nurse must remove the prosthesis for cleaning and to inspect the eye socket. The nurse has washed hands and applied disposable gloves. What is the correct order of the remaining steps to removing the prosthesis?
I. Gently retract the upper lid.
II. Exert slight pressure below the eyelid and slip the index finger under the prosthesis.
III. Break suction and slide the prosthesis out of the eye.
IV. Gently retract the lower eyelid against the orbital ridge with the thumb.
What is the second step to removing the prosthesis?
A client with an artificial eye is too ill to remove the eye, but the lids are crusted and irritated, so the nurse must remove the prosthesis for cleaning and to inspect the eye socket. The nurse has washed hands and applied disposable gloves. What is the correct order of the remaining steps to removing the prosthesis?
I. Gently retract the upper lid.
II. Exert slight pressure below the eyelid and slip the index finger under the prosthesis.
III. Break suction and slide the prosthesis out of the eye.
IV. Gently retract the lower eyelid against the orbital ridge with the thumb.
What is the third step to removing the prosthesis?
A client with an artificial eye is too ill to remove the eye, but the lids are crusted and irritated, so the nurse must remove the prosthesis for cleaning and to inspect the eye socket. The nurse has washed hands and applied disposable gloves. What is the correct order of the remaining steps to removing the prosthesis?
I. Gently retract the upper lid.
II. Exert slight pressure below the eyelid and slip the index finger under the prosthesis.
III. Break suction and slide the prosthesis out of the eye.
IV. Gently retract the lower eyelid against the orbital ridge with the thumb.
What is the fourth step to removing the prosthesis?
If a nurse accidentally punctures a finger with a needle after withdrawing blood from a client, which of the following actions should be carried out first?
When withdrawing blood from a peripheral vein in the arm and using a tourniquet, what is the maximum duration of time in minutes that the tourniquet should be left in place? Record your answer as a whole number.
__________ min
Which of the following factors increase the risk of developing deep vein thrombosis (DVT)? Select all that apply.
Which of the following is the primary focus of cognitive behavioral therapy (CBT)?
The nurse is doing a digital removal of stool for a client with a large fecal impaction resulting from opioid use when the client feels faint, and assessment of vital signs shows a marked decrease in pulse. Which of the following is the most likely reason for the change in pulse rate?
A nurse reviewed a client’s progress in smoking cessation, praising the client for being successful but suggesting the client might stop having coffee in the morning since that caused an urge to smoke. Following this session, the client appeared upset and complained that the nurse believed she was doing poorly because she wanted a cigarette with her morning coffee. Which type of cognitive distortion is the client exhibiting?
Which of the following immunizations is usually administered to neonates within hours of birth?
A client who is to undergo electroconvulsive therapy for severe depression is quite anxious about the treatment and asks the nurse what to expect after treatment. Which of the following information should the nurse include? Select all that apply.
A 40-year-old male client has been diagnosed with Huntington’s disease and his spouse asks the nurse if their 3-year-old son should be tested to determine if the son inherited the genetic disorder. Which of the following is the most appropriate response?
Following femoral catheterization for percutaneous coronary intervention (PCI), the client has increasing pain in the catheterization site, and the nurse notes visible edema and induration surrounding the site. The nurse suspects a hematoma and notifies the physician. Which of the following interventions should the nurse anticipate? Select all that apply.
If both parents are carriers of the defective gene for a disease with an autosomal recessive inheritance, what percentage chance does each child have of inheriting the gene from both parents and developing the disorder? Record your answer as a whole number.
__________ %
A client has been diagnosed with immune thrombocytic purpura (ITP). Which of the following signs and symptoms indicate increased thrombocytopenia? Select all that apply.
A client seen in the emergency department for influenza asks for an antibiotic prescription. Which of the following guidelines are important in helping the client decrease the risk of developing an antibiotic-resistant infection? Select all that apply.
A fundamentalist Muslim woman and her spouse come to the emergency department when the pregnant woman develops premature contractions and slight vaginal bleeding; however, the only physician available is a male. Which of the following initial responses is most appropriate?
Two Mexican immigrant families live closely together and share goods, services, and childcare. To which of the following family structures does this model correspond?
A pregnant client is keeping a “kick count” log during the last trimester. Which of the following may indicate fetal distress?
Which of the following are intrinsic factors that increase risk of falls in older adults? Select all that apply.
A 65-year-old client who recently retired from many years of working full-time for a company has become increasingly unmotivated and states he feels as though he has no purpose. Which of the following recommendations are most appropriate? Select all that apply.
A 14-year-old client has been diagnosed with celiac disease after a long history of diarrhea, anemia, and weight loss. What type of diet does the nurse anticipate the client will require?
Which type of behavior modification is most likely to benefit a client who has a severe phobia regarding spiders?