NURSING 1429 Prep U Week 4 Quiz Questions & Answers
1. A client with carbon monoxide poisoning is treated in the emergency department of an acute care facility. Which clinical manifestations should the nurse expect in this client? Select all that apply.
dizziness
pulse oximetry of 99% on...
NURSING 1429 Prep U Week 4 Quiz
Questions & Answers
1. A client with carbon monoxide poisoning is treated in the emergency department of an acute
care facility. Which clinical manifestations should the nurse expect in this client? Select all
that apply.
✓ dizziness
✓ pulse oximetry of 99% on room air
✓ headache
✓ nausea and vomiting
2. A client arrives to the emergency department (ED), with reports of chest pain.
Electrocardiograph (ECG) exhibits an elevated ST segment. What are the priority actions by
the nurse? Select all that apply.
✓ improving myocardial oxygenation
✓ relieving pain
✓ reduce cardiac output
3. A nurse is caring for a client after a lung biopsy. Which assessment findings would
be anticipated? Select all that apply.
✓ respiratory rate of 28 breaths/minute
✓ oxygen saturation level of 94% on 3 L of oxygen
✓ client stating pain level of 4 out of 10 that decreases with pain medication
✓ client dozing when left alone but awakening easily
✓ pink tinged sputum expectorated with coughing
4. The nurse is caring for a client who has sickle cell disease (SCD). The client is reporting pain
in the back, chest, and extremities. The nurse anticipates that the client may present with
what other clinical manifestation(s)? Select all that apply.
✓ nausea
✓ hypertension
✓ tachypnea
✓ swelling
5. A neonate has been placed on cardiac and apnea monitoring in the neonatal nursery. The
nurse notes that the apnea alarm repeatedly triggers. Place the following actions in the order
they would be completed by the nurse. All options must be used.
✓ Perform a focused assessment on the neonate.
✓ Count the respiratory rate for 60 seconds.
✓ Silence the alarm to decrease environmental stimuli.
✓ Check all connections on the apnea monitor.
✓ Document the assessment findings, interventions, and neonate’s response.
6. The nurse working in a critical care unit is a caring for a client that experiences respiratory
arrest. In what order will the nurse respond? All options must be used.
✓ Call for emergency help.
✓ Begin emergency resuscitation.
,✓ Document the resuscitation.
✓ Complete an incident report.
✓ Alert the family to the event.
✓ Restock the room with emergency equipment.
,7. A client was admitted to the emergency department (ED) following a workplace accident and
has just experienced brainstem death. The nurse recognizes that the client is likely an
appropriate donor for tissue and organs. What actions related to organ donation should the
(ED) nurse perform?
✓ Ensure that the family has a quiet, private place to discuss their decision around tissue donation.
✓ Support and validate the decision that the client's family makes.
8. The unlicensed assistive personnel (UAP) reports to the registered nurse that a client
admitted with pneumonia is very diaphoretic. The nurse reviews the following vital signs in
the medical record obtained by the UAP. What should the nurse do? Select all that apply.
✓ Check the urine output.
✓ Ask the client to drink more fluids.
✓ Notify the health care provider (HCP).
✓ Administer acetaminophen as prescribed.
9. A nurse, on the pediatric unit, received shift handoff on a 15-month-old with the following
needs. Using Maslow’s hierarchy framework, prioritize the following nursing care activities
for the toddler. All options must be used.
✓ clearing the airway of thick secretions
✓ notifying the health care provider about suspected compartment syndrome
✓ changing a soiled diaper
✓ administering antipyretics for an axillary temperature of 103°F (39.4°C)
✓ progressing the diet after surgery
10. The nurse is teaching a client how to use a metered-dose inhaler. Place the steps for using
a metered-dose inhaler in order. All options must be used.
✓ Remove cap and hold the inhaler upright.
✓ Shake the inhaler.
✓ Tilt head back slightly and breathe out slowly all the way.
✓ Open mouth and position inhaler 1 to 2 in (2.5 to 5 cm) away from mouth.
✓ Press the button on the inhaler while breathing in.
✓ Breathe in slowly and deeply for as long as possible.
11. The nurse is caring for a pediatric client that is having an allergic reaction to food. Place the
nursing actions for providing care to this client in chronological order. All options must be
used.
✓ Assess respiratory effort.
✓ Administer a histamine blocker.
✓ Ask the family what foods the child is allergic to.
✓ Document the reaction.
✓ Provide teaching about medications.
12. A client on mechanical ventilation continues to be hypoxic following therapy with positive
end- expiratory pressure (PEEP). The nurse prioritizes what intervention to reduce oxygen
demand?
✓ Administer neuromuscular blockers.
13. The nurse is caring for a 7-year-old client with asthma on a pediatric medical unit. What
aspect of the client's medical history alerts the nurse to a higher risk for an acute, severe
asthma exacerbation?
, ✓ recently prescribed an oral corticosteroid
14. A nurse provides care for a client receiving oxygen from a nonrebreather mask. Which
nursing intervention has the highest priority?
✓ assessing the client's respiratory status, orientation, and skin color
15. A client with acute respiratory distress syndrome is showing signs of increased dyspnea.
The nurse reviews a report of blood gas values (see report). Which finding is abnormal?
✓ PaCO2
16. A client has a dull headache, is dizzy, and has an increased pulse rate. The results of arterial
blood gas analysis are as follows: pH 7.26; partial pressure of carbon dioxide, 50 mm Hg
(6.7 kPa); and bicarbonate, 24 mEq/L (24 mmol/L). These findings indicate which acid-base
imbalance?
✓ respiratory acidosis
17. A client admitted with multiple traumatic injuries receives massive fluid resuscitation. Later,
the physician suspects that the client has aspirated stomach contents. The nurse knows to
monitor closely for complications that include which of the following?
✓ acute respiratory distress syndrome (ARDS)
18. Immediately following an automobile accident, a 21-year-old client has severe pain in the
right chest from hitting the steering wheel and a compound fracture of the right tibia and
fibula and multiple lacerations and contusions. What is the priority nursing goal for this
client?
✓ Maintain adequate oxygenation.
19. A nurse is caring for a client following an elective bronchoscopy. Which intervention by the
nurse is most appropriate?
✓ Do not give the client anything by mouth until the gag reflex returns.
20. A nurse is assigned to triage the care of four clients. Which client should the nurse assess first?
✓ client with a sore throat who now has a muffled voice and is drooling
21. A nurse is caring for a client with tuberculosis. Which infection-control technique is the
priority when caring for this client?
✓ wearing an N95 respirator when caring for the client
22. A nurse is planning postoperative care for a client who has received a general anesthetic.
During the immediate postoperative period, which nursing assessment should the nurse be
most concerned about?
✓ heart rate of 130 bpm, blood pressure of 98/56 mm Hg, and inspirations of 24
23. A young adult is admitted to the emergency department after an automobile accident. The
client has severe pain in the right chest from contact with the steering wheel. What should the
nurse do first?
✓ Maintain adequate oxygenation.
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