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Exam Questions & Expertly
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A nurse is reviewing the medical record of a client who is receiving heparin therapy for treatment of DVT. Which of the following interventions should the nurse anticipate taking if the client's aPTT is 96 seconds?a. Increase the heparin infusion flow rate by 2 mL/hrb. continue to monitor the heparin infusion as prescribedc. request a prothrombin timed. stop the heparin infusion _____________Quiz____________? a -
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A nurse is providing teaching for a client who is 2 days post-op following a heart transplant. Which of the following statements should the nurse include in the teaching?a. "you may no longer be able to feel chest pain."b. "your level of activity tolerance will not change."c. "after 6 months, you will no longer need to restrict your sodium intake."d. "you will be able to stop taking immunosuppressants after 12 months." _____________Quiz____________? a -
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A nurse is assess a client in the emergency room who has a bradydysrhythmia. Which of the following findings should the nurse expect?A. confusionB. friction rubC. hypertensionD. dry skin
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A nurse in the emergency department is caring for a client who had an anterior MI. The client's history reveals she is 1 week post-op open cholecystectomy. The nurse should recognize that which of the following interventions is contraindicated?A. administering IV morphine sulfateB. administering oxygen at 2 :/min via nasal cannulaC. helping the client to the bedside commodeD. assisting with thrombolytic therapy _____________Quiz____________? D -
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A nurse is caring for a client who has endocarditis. Which of the following findings should the nurse recognize as a potential complication?A. ventricular depolarizationB. Guillain- Barre syndromC. myelodysplastic syndromeD. Valvular disease _____________Quiz____________? C -
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A nurse is caring for a client who presents to the ER with a BP of 254/138 mmHg. The nurse recognizes that the client is in a hypertensive crisis. Which of the following actions should the nurse take first?A. obtain blood samples for laboratory testingB. Tell the client to report vision changesC. Place the head of the bed at 45 degreesD. initiate an IV _____________Quiz____________? a -
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a nurse is caring for a client who has HF and is experiencing AF. The nurse should plan to monitor for and report which of the following findings to the provider immediately?a. slurred speechb. irregular pulsec. dependent edemad. persistent fatigue
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A nurse is caring for a client following insertion of a permanent pacemaker. Which of the following client statements indicates a potential complication of the insertion procedure?a. "I can't get rid of these hiccups."b. "I feel dizzy when i stand."c. "My incision site stings."d. "I have a headache." _____________Quiz____________? b -
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A nurse is providing discharge teaching for a client who has a prescription for the transdermal nitroglycerin patch. Which of the following instructions should the nurse include in the teaching?a. apply the new patch to the same site as the previous patchb. place the patch on an area of skin away from skin folds and jointsc. keep the patch on 24 hr per dayd. replace the patch at the onset of angina _____________Quiz____________? c -
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A nurse is caring for a client in the first hour following an aortic aneurysm repair. Which of the following findings can indicate shock and should be reported to the provider?a. serosanguinous drainage on dressingb. severe pain with coughingc. urine output of 20 mL/hrd. increase in temp from 36.C (98.2F)- 37.5C (99.5F) _____________Quiz____________? d -
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A nurse caring for a client following an abdominal aortic aneurysm resection. Which of the following is the priority assessment for this client?a. neck vein distentionb. bowel soundsc. peripheral edemad. urine output _____________Quiz____________? b -
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A nurse is watching a client's ECG monitor and notes that the client's rhythm has changed from a normal sinus rhythm to supraventricular tachycardia. The client is conscious with a HR of 200-210 bpm and has a faint radial pulse. The nurse should anticipate assisting with which of the following interventions?a. delivery of precordial thumpb. vagal stimulationc. administration of atropine IVd. defibrillation _____________Quiz____________? a -
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A nurse is providing discharge teaching for a client who has HF. The nurse should instruct the client to report which of the following findings immediately to the provider?a. weight gain of 2 lb in 24 hrb. inc of 10 mmHg in systolic BPc. dyspnea with exertiond. dizziness when rising quickly _____________Quiz____________? c -
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A nurse is admitting a client who has a leg ulcer and a history of DM. The nurse should use which of the following focused assessments to help differentiate between an arterial ulcer and a venous stasis ulcer?a. explore the clients family history of peripheral vascular diseaseb. note the presence or absence of pain at the ulcer sitec. inquire about the presence or absence of claudicationd. ask if the client has had a recent infection _____________Quiz____________? c -
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A nurse is reviewing the laboratory results of several clients who have peripheral arterial disease. The nurse should plan to provide dietary teaching for the client who has which laboratory values?a. Cholesterol 180 mg/dL, HDL 70 mg/dL, LDL 90 mg/dLb. Cholesterol 185 mg/dL, HDL 50 mg/dL, LDL 120 mg/dLc. Cholesterol 190 mg/dL, HDL 25 mg/dL, LDL 160 mg/dLd. Cholesterol 195 mg/dL, HDL 55 mg/dL, LDL 125 mg/dL
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A nurse is caring for a client who has dilated cardiomyopathy. The client reports increasing difficulty completing her daily 1-mile walks. The nurse should recognize that this is a finding of which of the following?a. left ventricular failureb. peripheral vasodilationc. pericardial effusiond. dec vascular volume _____________Quiz____________? c -
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A nurse is caring for a client who is scheduled for a coronary artery bypass graft in 2 hr. Which of the following client statements indicates a need for further clarification by the nurse?a. "My arthritis is really bothering me because I haven't taken my aspiring in a week."b. "My blood pressure shouldn't be high because I took my BP medication this morning."c. "I took my warfarin last night according to my usually schedule."d. "I will check my BP because I took a reduced dose of insulin this morning." _____________Quiz____________? c -
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A nurse is caring for a client who had an onset of chest pain 24 hr ago. The nurse should recognize that an increase in which of the following is diagnostic of a MI?a. myoglobinb. c- reactive proteinc. creatine kinase- MBd. Homocysteine _____________Quiz____________? d -
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a nurse is caring for a client who has a history of DVT and is receiving warfarin. Which of the following client findings provides the nurse with the best evidence regarding the effectiveness of the warfarin therapy?a. hemoglobin 14 g/dLb. minimal bruising of extremitiesc. reduced circumference of affected extremityd. INR 2.
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A client who has a new diagnosis of hypertension has a prescription for an ACE inhibitor. The nurse instructs the client about adverse effects of the medication. The client demonstrates an understanding of the teaching by stating that he will notify his provider if he experiences which of the following?a. tendon painb. persistent coughc. frequent urinationd. constipation _____________Quiz____________? a, b, c -
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A client is being evaluated in the ED for a possible brain attack (stroke). Assessment findings consistent with a brain attack include which of the following? (select all that apply)a. facial droopb. slurred speechc. weakness of affected extremityd. crackles in lungse. decreased urine output _____________Quiz____________? c -
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A client is admitted with a diagnosis of acute stroke. The provider orders "diet as tolerated." Before feeding this client, which nursing action is priority?a. determine client's food preferencesb. elevate the head of the bed 30 degreesc. assess client's swallowing reflexd. review serum albumin level to determine appropriate diet _____________Quiz____________? a -
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Which of the following recommendations is best for the nurse to suggest to a client as a way to keep BP under control?a. follow a regular exercise programb. attend a stress- reduction support groupc. avoid use of tobacco and limit alcohol intaked. increase intake of fruits and veggies
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when administering a new medication to an older client, the nurse understands that:a. the dose may need to be increased to greater-than-normal levelsb. close monitoring is needed because toxic levels may developc. the dose may need to be decreased to lower-than- normal levelsd. nausea and vomiting may develop rapidly and are common side effects in older adults _____________Quiz____________? d -
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A 59 year old man was admitted to the hospital with dysphagia, stating that he has been having more difficulty swallowing food, even when he has chewed it throroughly and drinks plenty of water. A CT scan shows an area for a possible esophageal tumor. The client unergoes a biopsy and is awaiting results. The client asks, "what am I going to do if this is cancer?" What is the most appropriate nursing response?a. "You will have surgery to remove it."b. "I would choose to get radiation."c. "The doctor will go over the options with you."d. "You sound as if you are concerned about the biopsy results." _____________Quiz____________? b -
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The client with a long history of osteoarthritis is at risk for developing GERD if he or she:a. weighs 220 poundsb. frequently takes NSAIDs for painc. consumes food with calcium supplementationd. has limited physical mobility _____________Quiz____________? a -
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A priority nursing intervention in the care of a client with a hiatal hernia is:a. providing nutrition educationb. promoting regular exercisec. providing medication educationd. instructing the client on signs and symptoms of intestinal strangulation
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Which assessment variable requires immediate intervention post esophagectomy?a. BP 170/88b. respiratory rate 28c. temp 38.1d. pain 6/ _____________Quiz____________? a -
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An older client diagnosed with bacterial gastroenteritis reports abdominal cramping, diarrhea, nausea, and vomiting, and fatigue for the past 24 hours. The nurse should monitor the client for what priority assessment?a. dehydrationb. hypokalemiac. hypernatremiad. perineal skin breakdown _____________Quiz____________? c -
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A client has recently been placed on corticosteroids as treatment for ulcerative colitis. the nurse should monitor the client's laboratory results for evidence of which condition?a. hypernatremiab. hypercalcemiac. hyperglycemiad. hyperkalemia _____________Quiz____________? c -
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What priority laboratory analysis should the nurse review when caring for a client with Crohn's disease?a. c-reactive proteinb. serum albuminc. hemoglobind. potassium _____________Quiz____________? d -
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A client receiving chemotherapy for treatment of cancer is at greatest risk for developing:a. Stomatitisb. Xerostomac. oral abscessd. candidiasis _____________Quiz____________? c -
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A 26-year-old female client informs the nurse that she has had red, raised lesions at the base of the tongue and on the inside of her mouth for the past 2 weeks. What question should the nurse ask the client?a. "Have you seen a dentist recently?"b. "Do you smoke cigarettes?"c. "Do you have a history of HIV?"d. "What type of work do you do?" _____________Quiz____________? a -
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An older client with poor oral hygiene was admitted after a fall in which he sustained a fractured hip. What is the priority nursing intervention?a. initiate oral care every 6 hoursb. implement aspiration precautionsc. use lemon glycerin swabs to moisten the mouth as neededd. request a consult with a registered dietitian _____________Quiz____________? b -
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A nurse is reviewing the prescriptions for a client who has Campylobacter enteritis. Which of the following prescriptions should the nurse clarify with the provider?a. 0.45% sodium chloride IVb. Milk of Magnesiac. Ciprofloxacind. Potassium _____________Quiz____________? d -
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A nurse is caring for a client who has GERD and a new prescription for metoclopramide. The nurse should plan to monitor for which of the following adverse effects?a. Thrombocytopeniab. hearing lossc. hypotensiond. ataxia _____________Quiz____________? b -
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A nurse is caring for a client who has colorectal cancer and is recieving chemotherapy. The client asks the nurse why blood is being drawn for a carcinoembryonic antigen (CEA) level. Which of the following responses by the nurse is appropriate?a. "The CEA determines the current stage of you colon cancer."b. "The CEA determines the efficacy of your chemotherapy."c. "The CEA determines if the neutrophil count is below the expected reference range."d. "The CEA determines if you are experiencing occult bleeding from the GI tract." _____________Quiz____________? d -
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A nurse is providing discharge teaching for a client who has chronic cholecystitis. Which of the following food selections by the client indicated the teaching was effective?a. unsalted nutsb. bolognac. cheddar cheesed. bananas _____________Quiz____________? a -
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A nurse is providing discharge for a client who has gastritis and a new prescription for famotidine. Which of the following client statements indicated the teaching was effective?a. "I should make sure the water I drink is filtered."b. "I should expect immediate pain relief after starting this therapy."c. "I will drink iced tea with my meals and snacks."d. "I will monitor by blood glucose level regularly while taking this medication." _____________Quiz____________? c -
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A nurse is assessing a client who is postoperative following a gastrectomy. The nurse should identify which of the following findings as an indication of acute gastric dilation?a. hiccupsb. elevated BPc. bradycardiad. left lower quadrant pain _____________Quiz____________? c -
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A nurse is caring for a client who has hepatic encephalopathy. The client asks the nurse if she can have a larger portion of beef for dinner. Which of the following responses by the nurse is appropriate?a. "Beef is too high in fat, but can i request chicken as a substitute."b. "You need to increase your fluid intake. Would you like beef and noodle soup?"c. "You should limit your animal protein intake. Can I get you a veggie burger instead?"d. "You need to limit calories. Would you like some sugar-free gelatin?" _____________Quiz____________? d -
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Immunity that is developed by vaccination or immunization is known as:a. natural activeb. passive acquiredc. innate/natived. artificial active _____________Quiz____________? c -
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A patient with inflammation has a high eosinophil count. The nurse recognizes that this finding most likely indicated that:a. humoral and cell-mediated immunity is being stimulatedb. the inflammatory response has been stimulated by infectionc. tissue damage has been caused by an allergen-antibody reactiond. the inflammation has become chronic with persistent tissue damage _____________Quiz____________?
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Which cell types associated with the inflammatory response participate in phagocytosis?a. neutrophils and eosinophilsb. macrophages and neutrophilsc. macrophages and eosinophilsd. eosinophils and basophils _____________Quiz____________? b -
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A nurse is providing discharge teaching for a client who has chronic hepatitis C. which of the following statements by the client indicates an understanding of the teaching?a. "I will avoid alcohol until I'm no longer contagious."b. "I will avoid medications containing acetaminophen."c. "I will decrease my intake of calories."d. "I will need treatment for 3 months." _____________Quiz____________? c -
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A nurse is providing discharge teaching for an older adult client who has mild diverticulitis. which of the following client statements indicates an understanding of the teaching?a. "I may experience right lower quadrant pain."b. "I will remain active by working in my garden every day."c. "I should eat foods that are low in fiber."d. "I will use a mild laxative every day." _____________Quiz____________? a -
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A nurse is providing discharge teaching for a client who has GERD. Which of the following client statements indicates the teaching was effective?a. "I will decrease the amount of carbonated beverages I drink."b. "I will avoid drinking liquids for 30 minutes after taking a chew-able antacid tablet."c. "I will eat a snack before going to bed."d. "I will lie down for at least 30 minutes after eating each meal." _____________Quiz____________?
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A nurse is reviewing the laboratory values of a client who has colorectal cancer. Which of the following findings should the nurse expect?a. negative fecal occult blood testb. decreased serum carcinoembryonic antigen (CEA) levelc. hemocrit 43%d. hemoglobin 9.1 g/dL _____________Quiz____________? b -
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A nurse is reviewing the laboratory results of a client who has acute pancreatitis. Which of the following findings should the nurse expect?a. blood glucose 110 mg/dLb. Increased serum amylasec. WBC 9,000/mm^3d. Decreased bilirubin _____________Quiz____________? d -
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A nurse is caring for a client who has duodenal ulcer. which of the following findings should the nurse expect?a. the client described the pain as spasms in the right lower quadrant of the stomachb. the client describes the pain as pressure felt in the epigastriumc. The client states the pain occurs as soon as food enters the stomachd. the client states the pain occurs 1.5-3 hrs after meals and during the night _____________Quiz____________? a -
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A nurse is assessing a client who has acute hepatitis B. Which of the following findings should the nurse expect?a. joint painb. obstipationc. abdominal distentiond. periumbilical discoloration _____________Quiz____________? a -
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A nurse is assessing a client who has Crohn's disease. Which of the following findings should the nurse expect?a. Fatty, diarrheal stoolsb. Hyperkalemiac. weight gaind. sharp epigastric pain _____________Quiz____________? b -
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A nurse is providing teaching for a client who has cirrhosis and a new prescription for lactulose. The nurse should include which of the following instructions in the teaching?a. Notify the provider if bloating occursb. expect to have two to three soft stools per dayc. restrict carbs in the dietd. limit oral fluid intake to 1000 mL/day of clear liquids _____________Quiz____________? c -
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A nurse is admitting a client who has acute pancreatitis. Which of the following actions should the nurse take first?a. insert an NG tubeb. administer ceftazidimec. identify the clients current level of paind. instruct the client to remain NPO _____________Quiz____________? c -
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A nurse is teaching a client how to prepare for a colonoscopy. which of the following instructions should the nurse include in the teaching?a. begin drinking the oral liquid preparation for bowel cleansing on the morning of the procedureb. drink full liquids for breakfast the day of the procedure, and then take nothing by mouth for 2 hr prior to the procedurec. drink clear liquids for 24 hr prior to the procedure, and then take NPO by mouth for 6 hr before the procedured. Drink oral liquid preparation for bowel cleansing slowly _____________Quiz____________? a -
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