NUR 425 EXAM 1 NEWEST 2024-2025
COMPLETE 100 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+||BRAND
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When titrating an analgesic to manage pain, what is the priority
goal?
A. Administer smallest dose that provides relief with the fewest
side effects.
B. Titrate upward until the client is pain free.
C. Titrate downwards to prevent toxicity.
D. Ensure that the drug is adequate to meet the client's
subjective needs. - ANSWER- A (The goal is to control pain
while minimizing side effects. For severe pain, the medication
can be titrated upward until pain is controlled. Downward
titration occurs when the pain begins to subside. Adequate
dosing is important; however, the concept of controlled dosing
applies more to potent vasoactive drugs.)
For a cognitively impaired client who cannot accurately report
pain, what is the first action that you should take?
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A. Closely assess for nonverbal signs such as grimacing or
rocking.
B. Obtain baseline behavioral indicators from family members.
C. Look at the MAR and chart, to note the time of the last dose
and response.
D. Give the maximum PRS dose within the minimum time
frame for relief. - ANSWER- B (Complete information from the
family should be obtained during the initial comprehensive
history and assessment. If this information is not obtained, the
nursing staff will have to rely on observation of nonverbal
behavior and careful documentation to determine pain and relief
patterns.)
A nurse is assessing an electrocardiogram rhythm strip. The P
waves and QRS complexes are regular. The PR interval is 0.16
second, and QRS complexes measure 0.06 second. The overall
heart rate is 64 beats per minute. The nurse assesses the cardiac
rhythm as:
A. Normal sinus rhythm
B. Sinus bradycardia
C. Atrial fibrillation
D. First-degree heart block. - ANSWER- A (This rhythm is
NSR. The P waves and QRS complexes are regular. The PR
interval is less than 0.2 seconds. The QRS complex is less than
0.12 seconds. The heart rate is between 60-100 BPM.)
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A nurse notices frequent artifact on the ECG monitor for a client
whose leads are connected by cable to a console at the bedside.
The nurse examines the client to determine the cause. Which of
the following items is *unlikely* to be responsible for the
artifact?
A. Frequent movement of the client
B. Tightly secured cable connections
C. Leads applied over hairy areas
D. Leads applied to the limbs - ANSWER- B (Motion artifact,
or "noise," can be caused by frequent client movement,
electrode placement on limbs, and insufficient adhesion to the
skin, such as placing electrodes over hairy areas of the skin.
Electrode placement over bony prominences also should be
avoided. Signal interference can also occur with electrode
removal and cable disconnection.)
A nurse is watching the cardiac monitor and notices that the
rhythm suddenly changes. There are no P waves, the QRS
complexes are wide, and the ventricular rate is regular but over
100. The nurse determines that the client is experiencing:
A. Premature ventricular contractions
B. Ventricular tachycardia
C. Ventricular fibrillation
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D. Sinus tachycardia - ANSWER- B (Ventricular tachycardia is
characterized by the absence of P waves, wide QRS complexes
(usually greater than 0.14 second), and a rate between 100 and
250 impulses per minute. The rhythm is usually regular.)
A nurse is viewing the cardiac monitor in a client's room and
notes that the client has just gone into ventricular tachycardia.
The client is awake and alert and has good skin color. The nurse
would prepare to do which of the following?
A. Immediately defibrillate
B. Prepare for pacemaker insertion
C. Administer amiodarone (Cordarone) intravenously
D. Administer epinephrine (Adrenaline) intravenously -
ANSWER- C (First-line treatment of ventricular tachycardia in a
client who is hemodynamically stable is the use of anti-
dysrhythmics such as amiodarone (Cordarone), lidocaine
(Xylocaine), and procainamide (Pronestyl). Cardioversion also
may be needed to correct the rhythm (cardioversion is
recommended for stable ventricular tachycardia). Defibrillation
is used with pulseless ventricular tachycardia. Epinephrine
would stimulate and already excitable ventricle and is
contraindicated.)
A nurse is caring for a client with unstable ventricular
tachycardia. The nurse instructs the client to do which of the
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