NUR 336 Putting it all together Questions With Complete
Solutions
a charge nurse is anticipating the admission of four clients and
planning their room assignments. which of the following clients
should the nurse assign to the room closest to the nurses station?
a. a client who sustained a head injury and is having periods of
confusion
b. a client who reports a severe migraine HA
c. a client who has a suspected dx of TB
d. a client w/a hx of A-fib and in on continuous ECG monitoring
Correct Answers a. a client who sustained a head injury and is
having periods of confusion
A client is admitted to the ER with a respiratory rate of 7/min.
ABGs reveal the following values. Which of the following is an
appropriate analysis of the ABGS. pH 7.22 PaCO2 68 mm Hg
HCO3 26 mEq/L?
A. respiratory acidosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis Correct Answers A. Respiratory
acidosis
a client was prescribed fluticasone/salmeterol. for which of the
following adverse effects should the nurse instruct the client to
report to the provider?
A. sedation
B. increased appetite
C. white coating in the mouth
,D. dry oral mucus membranes Correct Answers C. white
coating in the mouth
a home health nurse visits a client who has COPD and receives
O2 at 2L/min via nasal cannula. The client reports difficulty
breathing. Which of the following actions is the nurse's priority?
A. increase oxygen flow to 3 L/min
B. assess the client's respiratory status
C. call emergency services for the client
D. have the client cough and expectorate secretions Correct
Answers B. assess the client's respiratory status
a nurse assessing a client determinea that he is in the
compensatory stage of shock. Which of the following findings
support this conclusion?
A. confusion
B. BL 84/50
C. anuria
D. petechiae Correct Answers A. confusion
A nurse if monitoring a client who is receiving blood
transfusion. Which of the following findings indicates an alergic
transfusion reaction?
A. generalized urticaria
B. BP 184/92
C. JVD
D. bilateral flank pain Correct Answers A. generalized urticaria
a nurse in a cardiac care unit is caring for a client with acute righ
sided HF. Which of the following findings should the nurse
expect?
,A. decreased BNP
B. elevated central venous pressure
C. increased pulmonary artery wedge pressure
D. decreased specific gravity Correct Answers B. elevated
central venous pressure
A nurse in a clinic sees a client who has an acute asthma
exacerbation. Which of the following meds should reduce the
symptoms?
A. Cromolyn via metered dose
B. Montelukast PO
C. Budesonide via dry powder inhaler
D. Albuterol via jet nebulizer Correct Answers D. Albuterol
via jet nebulizer
Rationale: The nurse should identify that albuterol is a
bronchodilator used as the first medication of choice to stop
bronchospasm or constriction in clients who have acute asthma
exacerbation.
A nurse in a critical care unit is caring for a client who is postOp
following a right pneumonectomy. After extubation from the
ventilator, in which of the following positions should the client
be placed?
A. Prone
B. on the nonoperative side
C. Sims
D. Semi-fowlers Correct Answers D. Semi-fowlers
a nurse in a long term care facility is caring for an older adult
client who had a stroke 4 weeks ago and who is unable to move
, independently. The nurse should monitor for which of the
following complications of immobility?
a. a reddened area over the sacrum
b. stiffness in the lower extremities
c. difficulty moving the upper extremities
d. difficulty hearing some types of sounds Correct Answers a. a
reddened area over the sacrum
A nurse in a rehab center is performing an assessment for a
client who is recovering from a left hemisphere stroke. Which of
the following findings should the nurse expect?
A. Reduced left side motor function
B. Difficulty with speech
C. Impulsive behavior
D. Neglect of the left side of the body Correct Answers B.
Difficulty with speech
Rationale: The left hemisphere of the brain is usually the
dominant side and is responsible for language. This is always
true for right-handed clients and for the majority of left-handed
clients. Since this client is recovering from a left-hemisphere
stroke, the nurse should anticipate that the client will have
aphasia and require speech therapy to establish communication.
A nurse in an intensive care unit is providing teaching for a
client prior to removal of an ET tube. Which of the following
instructions should the nurse include in the teaching?
A. Rest in a side lying position after the tube is removed
B. Use the incentive spirometer every 4 hours after the tube is
removed.
C. Avoid speaking for long periods
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