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RN Comprehensive Online Practice 2024 B QUESTIONS AND ANSWERS GRADED A+
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RN Comprehensive Online Practice 2024 B QUESTIONS AND ANSWERS GRADED A+
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RN Comprehensive Online Practice2024 B
A nurse is worrying for a five-12 months-antique toddler
Physical Examination:
1510:
Upon visual inspection, throat is infected, tonsils appear purple, reddened and epiglottis is
edematous and cherry pink in appearance. Skin seems light. Stridor referred to upon notion
with faded bilateral lung sounds.
Nurse's Notes:
1500
Child observed to emergency department with the aid of caregiver. Caregiver states toddler
has a sore throat and reports the kid has "ache on swallowing" and denies cough. Child is
agitated and lean - ANSCondition: Epiglottis
Actions: Initiate droplet precautions and request a prescription for IV antibiotics
Monitors: Breath sounds and temperature
The nurse have to anticipate starting up droplet precautions and soliciting for a prescription
for IV antibiotics. The infant is maximum probably experiencing epiglottis because of the
scientific manifestations of a excessive fever, inflammation and redness of the throat, pale
skin, stridor with idea, painful swallowing, no cough, is sitting in tripod role, and drooling. The
nurse ought to monitor the kid's temperature and breath sounds.
A nurse is being concerned for a consumer who is on the spinal wire damage (SCI) unit
Nurses' Notes
Day three, 1700
Client admitted to SCI unit three days in the past following C7 harm. Skin is cool, faded, and
dry to the touch. Respirations smooth and unlabored. Lung sounds diminished in lower
lobes. Abdomen soft and nondistended with lively bowel sounds. Client surpassed a small
amount of hard shaped stool this AM. Indwelling urinary catheter draining clear yellow urine.
Deep tendon reflexes (DTR) are biceps 1+, triceps 1+, pa - ANSThe customer is most
possibly experiencing manifestations of pneumonia and autonomic dysreflexia.
The nurse should examine cues from the patron's manifestations and decide that the
consumer is maximum likely experiencing manifestations of pneumonia and autonomic
dysreflexia. A consumer who has a cervical SCI is at risk for respiratory headaches because
spinal innervation to the breathing muscle tissues is disrupted. Adventitious breath sounds in
the decrease lobes bilaterally and a decrease in oxygen saturation to less than ninety two%
can indicate pneumonia. The patron's sudden boom in blood stress, bradycardia, flushing of
the skin above the vicinity of the injury, headache, and blurred vision are manifestations of
autonomic dysreflexia, which may be a life-threatening situation.
,A nurse is being concerned for a customer who has stomach pain
Nurses' Notes
0900
Client reports lack of appetite, weight reduction, and fatigue for 1 week. Reports belly ache,
6 on a scale from zero to 10, for 2 days. Client is a perioperative nurse, lower back 1 week
ago from a 2-week assignment trip to an underdeveloped u . S .
1200
Results of antibody research acquired. Provider prescription for antiviral medicine pending.
Physical Examination
0930
Lung sounds clean bilaterally. Skin warm to the touch and jau - ANSHepatitis A: Client's
chance from fecal-oral transmission, laboratory results, and bodily examination findings
Hepatitis B: Antiviral remedy, laboratory results, purchaser's risk from bloodborne
transmission, physical examination findings
Hepatitis C: Antiviral treatment, laboratory consequences, customer's hazard from
bloodborne transmission, and bodily exam findings
When analyzing cues, the nurse ought to apprehend that manifestations of hepatitis A,
hepatitis B, and hepatitis C consist of jaundice, yellow sclerae, proper top quandrant ache
upon palpation, darkish yellow urine, and multiplied AST and ALT stages. When analyzing
cues, the nurse have to additionally recognize the purchaser's chance for contracting
hepatitis A via the fecal-oral direction throughout latest journey to an underdeveloped us of a
and the client's occupational threat as a perioperative nurse for contracting hepatitis B and
hepatitis C via bloodborne transmission. The nurse need to apprehend that the present day
wellknown of exercise for
A nurse is being concerned for a patron on a clinical-surgical unit
Vital Signs
0700
Temperature 37.6 C (ninety nine.7 F)
Heart rate one hundred/min
Respiratory charge 22/min
Blood strain a hundred and fifteen/70 mmHg
Oxygen saturation 98% on room air
Nurses' Notes
1100
Client alert and orientated to character, region, and time. Client had episode of diarrhea,
provided perineal care. Noted 2 cm x 2 cm (zero.Eight in x zero.Eight in) painful edematous
location on sacrum. Client repositioned every 4 hr. - ANSClick to spotlight the findings that
require observe up. To deselect a locating, click on on the finding once more.
,- Noted 2 cm x 2 cm (zero.Eight in x zero.Eight in) painful edematous place on sacrum
- Client repositioned each 4 hr
When recognizing cues, the nurse must determine that the consumer's painful edematous
region on their sacrum and that the consumer has most effective been repositioned every 4
hr requires follow up. The consumer has manifestations of a stress harm that need to be
addressed. The consumer need to be repositioned at least every 2 hr to save you worsening
of the stress injury and to alleviate stress from the sacral area.
A nurse in an outpatient intellectual fitness clinic is caring for a client
Vital Signs
three months in the past
Blood strain 116/sixty eight mmHg
Heart fee 82/min
Respiratory charge sixteen/min
Temperature 36.7 C (98.1 F)
SaO2 ninety seven% on room air
Today:
Blood pressure 128/seventy six mmHg
Heart fee 104/min
Respiratory price 22/min
Temperature 37.4 (ninety nine.Four F)
SaO2 ninety seven% on room air
Nurses' Notes
three months ago
Client recently admitted with new analysis of schizophrenia. Received inpatient treatment for
10 days and became discharged 1 week in the past. - ANSSelect the three findings that
require on the spot follow up:
- Auditory hallucinations
- Speech
- Restlessness
When spotting cues, the nurse need to perceive that the findings of restlessness, auditory
hallucinations, and compelled speech require immediate comply with up. These findings are
indicators of psychosis. The nurse need to notify the company for additional evaluation and
remedy.
A nurse is worrying for a customer who is postoperative following coronary artery skip
surgery (CABG)
Laboratory Results
0630
Sodium one hundred forty five mEq/L (136 to one hundred forty five mEq/L)
Potassium 3.2 mEq/L (three.5 to 5 mEq/L)
Chloride 116 mEq/L (ninety eight to 106 mEq/L)
, BUN 24 mg/dL (10 to 20 mg/dL)
Magnesium 1.Five mEq/L (1.Three to two.1 mEq/L)
Total calcium 9 mg/dL (9 to 10.5 mg/dL)
Phosphate four.6 mg/dL (3 to 4.Five mg/dL)
Glucose ninety five mg/dL (seventy four to 106 mg/dL)
WBC count nine,500/mm3 (five,000 to ten,000/mm3)
I&O
0700
four hr input four hundred mL
four hr output - ANSThe purchaser is at finest hazard for developing dysrhythmias, as
evidenced by using electrolyte imbalance.
The nurse ought to examine cues to decide the client is at greatest risk for growing
dysrhythmias associated with hypokalemia, as evidenced with the aid of the laboratory
record and the purchaser's file of muscle cramping. Potassium and magnesium depletion are
common manifestations in customers who are postoperative following CABG. Due to
medicine or hemodilation, it's far critical for the nurse to closely display electrolytes.
A nurse is being concerned for a patron who's pregnant in the acute care putting
Nurses' Notes
1400
Client reports a consistent low dull backache and painless abdominal tightening for the past
three hr. Denies any modifications in vaginal discharge. External fetal display applied.
1430
Contraction sample: contractions each 4 to 5 min, lasting 30 to 45 seconds, palpate mild in
depth
Fetal heart rate: 150/min to one hundred fifty five/min, moderate variability, adequate
accelerations present, no decelerations stated. Provider in - ANSThe nurse need to first
cope with the consumer's breathing fee, followed with the aid of the customer's degree of
focus
When prioritizing hypotheses, the nurse ought to recognize that magnesium sulfate is a
relevant nervous device depressant that could have an effect on respirations, cognizance,
and reflexes whilst poisonous blood degrees occur. Using the airway, respiratory, move
precedence framework, the nurse have to plan to first take action to help respirations,
followed by way of motion to increase the client's level of awareness. The nurse must plan to
discontinue the magnesium sulfate infusion and administer calcium gluconate as an
antidote.
A nurse is caring for a young person in the emergency department (ED)
Nurses' Notes
0700
Adolescent admitted to ED. Adolescent's mother and father are involved about left leg harm
that looks to be getting worse. Parents record adolescent has had fever, decreased urge for
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