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NUR310 FINAL EXAM|| ACTUAL EXAM ALL
QUESTIONS AND 100% CORRECT ANSWERS WITH
RATIONALES ALREADY GRADED A+|| LATEST
AND COMPLETE VERSION 2024-2025 WITH
EXPERT VERIFIED SOLUTIONS|| ASSURED PASS!!!
A client is admitted to the hospital with a diagnosis of Crohn disease. What is most
important for the nurse to include in the teaching plan for this client?
A. Controlling constipation
B. Meeting nutritional needs
C. Preventing increased weakness
D. Anticipating a sexual alteration - ANSWER: B
To avoid GI pain and diarrhea, these clients often reuse to eat and become
malnourished. The consumption of a high-calorie, high-protein diet is advised.
Diarrhea, not constipation, is a problem with Crohn disease. Preventing an increase
in weakness is a secondary concern that results from malnutrition; correcting the
malnutrition will increase strength.
A client was diagnosed with ulcerative colitis. Two months after the diagnosis, the
client is readmitted for an exacerbation of the illness. The client is weak, thin, and
irritable. The client states, "I am now ready for surgery to create an ileostomy."
Which nursing intervention will best meet the client's priority need?
A. Replace the client's fluids and electrolytes
B. Help the client gain weight
C. Teach the client how to use the ileostomy appliance
D. Encourage client interaction with other clients who have an ileostomy -
ANSWER: A
When a client has an ulcerative colitis exacerbation, the client may have over 10
stools per day and the stools are bloody and full of mucus. The client can become
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dehydrated and loose vital electrolytes. Fluid and electrolyte replacement is a life-
saving strategy; it must be done before surgery is performed.
A woman fractured her left tibia and fibula one week ago and has a cast in place.
She is taking acetaminophen (Tylenol) with codeine for pain and an oral
contraceptive. She began experiencing left calf pain 3 days ago and began having
shortness of breath and chest pain 15 minutes ago. When the shortness of breath
and chest pain increase, she calls the emergency department and communicates
this information to the triage nurse. What is the triage nurse's best response?
A. "Give me your name and address. I am sending an ambulance to your home.
You need emergency care."
B. "It sounds as if your cast may be constricting the blood flow in your leg. You
probably need a new cast."
C. "It sounds like you are having an allergic response to the medication. is there
someone there who can drive you to the hospital?"
D. "You are experiencing an interaction between your pain and oral contraceptive
medications. You need to come to t - ANSWER: A
The client's clinical manifestations, along with the history of a recent fracture,
immobilization, and use of an oral contraceptive, suggest a pulmonary embolism.
An ambulance will limit the woman's use of her leg, which may prevent further
emboli. The client's findings are not indicative of compression syndrome.
To prepare a client for surgery, which explanation by a nurse would be accurate
related to pneumatic compression devices?
A. They help the venous blood return to the heart.
B. They will not cause discomfort, but gently massage the legs.
C. They are used instead of anticoagulant therapy.
D. They must be worn until the first time the client gets out of bed. - ANSWER: A
DVT is a potential complication of any surgery lasting longer than 30 minutes. The
purpose of pneumatic compression devices is to venous return. In addition to the
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pneumatic compression devices, a mechanical form of DVT prophylaxis, a
pharmaceutical prophylaxis is often required. Pneumatic compression devices are
continued until the client is up ambulating frequently throughout the day.
A mother arrives in the emergency department with her severely dehydrated infant.
After being treated aggressively, the infant is rehydrated and ready to be
discharged. What is the priority concern that the nurse should include in the
discharge teaching plan for the mother?
A. Importance of a well-balanced diet
B. Signs of dehydration in infants
C. The need for cleanliness of feeding utensils.
D. Effect of antibiotics on viral gastroenteritis. - ANSWER: B
It is most important for the mother to learn that immediate treatment is necessary
for an infant with vomiting or diarrhea. Because infants have a greater proportion
of body fluid to tissue than adults, they cannot maintain fluid balance in the event
of a large loss of fluid through vomiting or diarrhea.
A nurse is assessing a client with a diagnosis of psoriasis. Which clinical findings
should the nurse expect to observe? Select all that apply.
A. Scaly lesions
B. Pruritic pustules
C. Reddened papules
D. Multiple petechiae
E. Erythematous macules - ANSWER: A, C
Psoriasis is characterized by dry, scaly lesions that occur most frequently on the
elbows, knees, scalp, and torso. Sharply defined reddened papules or plaques
covered by scales occur because of dermal inflammation; the inflammation occurs
because of an abnormal growth of epidermal cells related to an autoimmune
reaction.
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Macules are erythematous flat spots on the skin, as in measles.
The nurse is caring for a client who has sustained blunt trauma to the forearm. The
nurse assesses the client for which early sign of compartment syndrome?
A. Warm skin at the site of injury
B. Escalating pain in the fingers
C. Rapid capillary refill in affected hand
D. Bounding radial pulse in the injured arm - ANSWER: B
Elevated tissue pressure restricts blood flow, causing increasing ischemia and
increasing pain; it is the cardinal early symptom of compartment syndrome. The
arm will feel cool, not warm, because of a decrease in circulation. Sluggish, not
rapid, capillary refill is a sign of compartment syndrome. The pulse will be
diminished, not bounding; increasing edema impairs circulation.
A client sustains a complex comminuted fracture of the tibia with soft tissue
injuries after being hit by a car while riding a bicycle. Surgical placement of an
external fixator is performed to maintain the bone in alignment. Postoperatively it
is most essential for the nurse to do what?
A. Cleanse the pin sites with alcohol several times a day.
B. Perform a neurovascular assessment of both lower extremities.
C. Ambulate the client with partial weight bearing on the affected leg.
D. Maintain placement of an abduction pillow between the client's legs. -
ANSWER: B
A neurovascular assessment identifies early signs and symptoms of compartment
syndrome. Compartment syndrome is increased pressure within a closed fascial
space caused by a fracture or soft tissue damage that compresses circulatory
vessels, nerves, and tissues, compromising viability of the limb. The nurse should
monitor for the six Ps: unrelenting pain, pallor, paresthesia, pressure, pulselessness,
and paralysis. In addition, the circumference of the extremity will increase, and the
leg will feel hard and firm on palpation. Both legs are assessed for asymmetry .
