Exam (elaborations)

child who has recently been diagnosed with cystic fibrosis is in a pediatric clinic where a nurse is performing an assessment.

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Course
NURSING 495

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NURSING 495

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Uploaded on May 14, 2022
Number of pages 172
Written in 2021/2022
Type Exam (elaborations)
Contains Questions & answers

which individual is at greatest risk for developing hypertension
gastric lavage prn
acetylcysteine mucomyst for age per pharmacy
activated charcoal per pharmacy
start an iv dextrose 5 with 0

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NURSING 495 NNMCB Combined Questions
with Answers provided

1. Which individual is at greatest risk for developing hypertension?

A. 45-year-old African American attorney
B. 60-year-old Asian American shop owner
C. 40-year-old Caucasian nurse
D. 55-year-old Hispanic teacher

1. Answer: A: 45-year-old African American attorney

The incidence of hypertension is greater among African Americans than other groups in the US.
The incidence among the Hispanic population is rising.

2. A child who ingested 15 maximum strength acetaminophen tablets 45 minutes ago is seen
in the emergency department. Which of these orders should the nurse do first?

A. Gastric lavage PRN
B. Acetylcysteine (Mucomyst) for age per pharmacy
C. Start an IV Dextrose 5% with 0.33% normal saline to keep vein open
D. Activated charcoal per pharmacy

2. Answer: A: Gastric lavage PRN

Removing as much of the drug as possible is the first step in treatment for this drug overdose.
This is best done by gastric lavage. The next drug to give would be activated charcoal, then
mucomyst and lastly the IV fluids.

3. Which complication of cardiac catheterization should the nurse monitor for in the
initial 24 hours after the procedure?

A. angina at rest
B. thrombus formation
C. dizziness
D. falling blood pressure

3. Answer: B: thrombus formation

Thrombus formation in the coronary arteries is a potential problem in the initial 24 hours after a
cardiac catheterization. A falling BP occurs along with hemorrhage of the insertion site which
is associated with the first 12 hours after the procedure.

,4. A client is admitted to the emergency room with renal calculi and is complaining
of moderate to severe flank pain and nausea. The client’s temperature is 100.8
degrees Fahrenheit. The priority nursing goal for this client is:

A. Maintain fluid and electrolyte balance
B. Control nausea
C. Manage pain
D. Prevent urinary tract infection

4. Answer: C: Manage pain

The immediate goal of therapy is to alleviate the client’s pain.

5. What would the nurse expect to see while assessing the growth of children during
their school age years?

A. Decreasing amounts of body fat and muscle mass
B. Little change in body appearance from year to year
C. Progressive height increase of 4 inches each year
D. Yearly weight gain of about 5.5 pounds per year

5. Answer: D: Yearly weight gain of about 5.5 pounds per year

School age children gain about 5.5 pounds each year and increase about 2 inches in height.

6. At a community health fair, the blood pressure of a 62-year-old client is 160/96
mmHg. The client states “My blood pressure is usually much lower.” The nurse should
tell the client to

A. go get a blood pressure check within the next 48 to 72 hours
B. check blood pressure again in two (2) months
C. see the health care provider immediately
D. visit the health care provider within one (1) week for a BP check

6. Answer: A: go get a blood pressure check within the next 48 to 72 hours

The blood pressure reading is moderately high with the need to have it rechecked in a few days.
The client states it is ‘usually much lower.’ Thus a concern exists for complications such as
stroke. However, immediate check by the provider of care is not warranted. Waiting 2 months
or a week for follow-up is too long.

,7. The hospital has sounded the call for a disaster drill on the evening shift. Which of
these clients would the nurse put first on the list to be discharged in order to make a room
available for a new admission?

A. A middle-aged client with a history of being ventilator dependent for over seven (7) years and
nmjadmitted with bacterial pneumonia five days ago.
B. A young adult with diabetes mellitus Type 2 for over ten (10) years and admitted with
antibiotic-induced diarrhea 24 hours ago.
C. An elderly client with a history of hypertension, hypercholesterolemia, and lupus, and
was admitted with Stevens-Johnson syndrome that morning.
D. An adolescent with a positive HIV test and admitted for acute cellulitis of the lower leg 48
hours ago.

7. Answer: A: A middle-aged client with a history of being ventilator dependent for over
7 years and admitted with bacterial pneumonia five days ago

The best candidate for discharge is one who has had a chronic condition and is most familiar
with their care. This client in option A is most likely stable and could continue medication
therapy at home.

8. A client has been newly diagnosed with hypothyroidism and will take levothyroxine
(Synthroid) 50 mcg/day by mouth. As part of the teaching plan, the nurse emphasizes
that this medication:

A. Should be taken in the morning
B. May decrease the client’s energy level
C. Must be stored in a dark container
D. Will decrease the client’s heart rate

8. Answer: A: Should be taken in the morning

Thyroid supplement should be taken in the morning to minimize the side effects of insomnia

9. A 3-year-old child comes to the pediatric clinic after the sudden onset of findings that
include irritability, thick muffled voice, croaking on inspiration, hot to touch, sit
leaning fordward, tongue protruding, drooling and suprasternal retractions. What
should the nurse do first?

A. Prepare the child for X-ray of upper airways
B. Examine the child’s throat
C. Collect a sputum specimen
D. Notify the healthcare provider of the child’s status

, 9. Answer: D: Notify the health care provider of the child’s status

These findings suggest a medical emergency and may be due to epiglottitis. Any child with an
acute onset of an inflammatory response in the mouth and throat should receive immediate
attention in a facility equipped to perform intubation or a tracheostomy in the event of further or
complete obstruction.

10. In children suspected to have a diagnosis of diabetes, which one of the following
complaints would be most likely to prompt parents to take their school age child
for evaluation?

A. Polyphagia
B. Dehydration
C. Bedwetting
D. Weight loss

10. Answer: C: Bedwetting

In children, fatigue and bed wetting are the chief complaints that prompt parents to take their
child for evaluation. Bed wetting in a school age child is readily detected by the parents.

11. A client comes to the clinic for treatment of recurrent pelvic inflammatory disease. The
nurse recognizes that this condition most frequently follows which type of infection?

A. Trichomoniasis
B. Chlamydia
C. Staphylococcus
D. Streptococcus

11. Answer: B: Chlamydia

Chlamydial infections are one of the most frequent causes of salpingitis or pelvic inflammatory
disease.

12. An RN who usually works in a spinal rehabilitation unit is floated to the
emergency department. Which of these clients should the charge nurse assign to this
RN?

A. A middle-aged client who says “I took too many diet pills” and “my heart feels like it is racing
out of my chest.”
B. A young adult who says “I hear songs from heaven. I need money for beer. I quit drinking two
(2) days ago for my family. Why are my arms and legs jerking?”
C. An adolescent who has been on pain medications terminal cancer with an initial
assessment finding pupils and a relaxed respiratory rate of 10,
D. An elderly client who reports having taken a “large crack hit” 10 minutes prior to walking
into the emergency room.

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Exam (elaborations)

child who has recently been diagnosed with cystic fibrosis is in a pediatric clinic where a nurse is performing an assessment.

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