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PNR 408- EXAM 2024 with Complete Solutions/ Correct-Verified Answers
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PNR 408- EXAM 2024 with Complete Solutions/ Correct-Verified Answers
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PNR 408- EXAM 2024 with CompleteSolutions/ Correct-Verified Answers
The RN may delegate tasks such as taking vital signs to NAP. Assessments (e.g., monitoring for
signs of a blood transfusion reaction [shortness of breath and back pain]) are within the scope
of practice of the RN and may not be delegated to UAP. The RN must also assume responsibility
for ensuring the correct IV fluid is used with blood products. A licensed nurse must complete
verification of the patient's identity and the blood product data.
Characteristics of a deep partial-thickness burn include all of the following except:
a.Weeping surface
b.Absence of edema
c.Broken epidermis
d.Mottled, red base - ANSWER B
Partial-thickness burns often have blisters that fill with edematous fluids
A patient is burned in a house fire. The burns cover the face and the left forearm.
What percentage of burn does the patient have?
A.10%
B.25%
C.9%
D.18% - ANSWER C - 4.5%+4.5% = 9%
,When monitoring initial fluid replacement for the patient with 40% TBSA deep partial-thickness
and full-thickness burns, which of the following findings is of most concern to the nurse?
A.Urine output of 35 mL/hr
B.Serum K+ of 4.5 mmol/L
C.Decreased bowel sounds
D.Blood pressure of 86/72 mm Hg - ANSWER D
During the emergent phase of burn injury, the nurse assesses for the presence of hypovolemia.
In burn patients, hypovolemia occurs primarily as a result of:
A.Blood loss from injured tissue.
B.Third spacing of fluid into fluid-filled vesicles.
C.Evaporation of fluid from denuded body surfaces.
D.Capillary permeability with fluid shift to the interstitium. - ANSWER D
Hypovolemic shock is caused by a massive shift of fluids out of the blood vessels as a result
of increased capillary permeability. Water, sodium, and plasma proteins move into
interstitial spaces and other surrounding tissue.
The nurse is admitting a client who has abdominal pain, nausea, and vomiting. A bowel
obstruction is suspected. The nurse assesses this client for which of the following
anticipated primary acid-base imbalances if the obstruction is high in the intestine?
a)Metabolic acidosis
b)Metabolic alkalosis
c)Respiratory acidosis
d)Respiratory alkalosis - ANSWER B
,Because gastric secretions are rich in hydrochloric acid, the client who is vomiting will lose
a significant amount of gastric acid and be at an increased risk for metabolic alkalosis.
Which of the following serum potassium results best supports the rationale for administering a
stat dose of potassium chloride 20 mmol in 250 mL of NSS over 2 hours?
a)3.1 mmol/L
b)3.9 mmol/L
c)4.6 mmol/L
d)5.3 mmol/L - ANSWER A
Normal K range = 3.5-5.0
The nurse receives a health care provider's prescription to change a client's IV from D5½NS
with 40 mmol KCl/L to D5NS with 20 mmol KCl/L. Which of the following serum laboratory
values, documented on this same client, best supports the rationale for this IV order change?
a)Sodium 136 mmol/L, potassium 4.5 mmol/L
b)Sodium 145 mmol/L, potassium 4.8 mmol/L
c)Sodium 135 mmol/L, potassium 3.6 mmol/L
d)Sodium 144 mmol/L, potassium 3.7 mmol/L - ANSWER A
We know that provider has upped the sodium concentration since the new order has a change
from 0.45NS to 0.9NS, so we would expect the Na level to be on the lower end of 135-145, so
either A or C.
The we know that the potassium level is likely getting close to the upper limit as the KCl conc
was decreased from 40 to 20mmol/L, which means we can eliminate C as a K level of 3.6 would
not be a reason to DECREASE the potassium infusion.
, The nurse is preparing an IV solution for administration. The health care providers prescription
is D5½ NS with 40 mmol KCl/L at 125 mL/hour. The nurse must add KCl to the IV because no
premixed solutions are available. The unit medication supply has a stock of KCl 3 mmol/mL in
multidose vials. Which of the following amounts of KCl should the nurse add to a litre of D5½
NS to obtain the correct solution?
10 mL
7.5 mL
13.3 mL
15 mL - ANSWER C
Have: 3mmol/mL
Need: 40mmol in the 1L bag
40mmol/3mmol = 13.3mL
The nurse is caring for a client admitted with an exacerbation of asthma. After several
treatments, the ABG results are pH 7.40, PaCO2 40 mm Hg, HCO3 24 mmol/L, PaO2 92 mm Hg,
and O2 saturation 99%. Which of the following interpretations would the nurse document?
a)Within normal limits
b)Slight metabolic acidosis
c)Slight respiratory acidosis
d)Slight respiratory alkalosis - ANSWER A
pH - within normal 7.35-7.45
PaCO2 - within normal 35-45mmHg
HCO3 - within normal 22-26mEq/L
PaO2 - within normal 80-100mmHg
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