Assessment 2019 B
, 1. A nurse is assessing a client who received 2 units of packed RBCs 48 hr.
ago. Whichof the following findings should indicate to the nurse that the
therapy has been effective?
a. Hemoglobin 14.9 g/dl
b. WBC count 12000/mm3
c. Potassium 4.8 mEq/L
d. BUN 18 mg/dl
2. A nurse working in an emergency department is triaging four clients.
Which of thefollowing clients should the nurse recommend for
treatment first?
a. An older adult client who reports constipation of 4 days.
b. A preschooler who has a skin rash.
c. An adolescent who has a closed fracture
d. A middle adult client who has unstable vital signs.
3. A nurse is caring for a client who has fluid volume overload. Which of the
followingtasks should the nurse delegate to an assistive personnel (AP)?
a. Palpate the degree of edema
b. Regulate IV pump fluid rate.
c. Measure the client’s daily weight.
d. Assess the client’s vital sign.
4. A nurse is preparing to administer mannitol 0.2 g/kg IV bolus over 5
min as a testdose to a client who has severe oliguria. The client weights
198 lb. What is the amount in grams the nurse should administer?
(Round the answer to the nearest whole number. Use a leading zero if
it applies. Do not use a trailing zero.)
a. 18 G
5. A nurse is conducting a physical examination for an adolescent and is
assessing the range of motion of the legs. Which of the following images
indicates the adolescent isabducting the hip joint?
E. La foto que está parado de frente y solo se ven pies que están separados uno
del otro hacia afuera. The image, on the adolescent is abducting the hip
,joint by moving the leg away fromthe midline of the body. (imagen with
patient facing you with her right leg lifted) answer quizlet (es la imagen con
el paciente frente a usted con la pierna derecha levantada).
, 6. A nurse is caring for a client who has hyperthyroidism. Which of the
followingfindings should the nurse expect?
a. Dry, coarse hair
b. Bradycard
iac. Tremors
d. Periorbital edema
7. A nurse is assessing a school-age child who has bacterial meningitis.
Which of thefollowing findings should the nurse expect?
a. Nuchal rigidity
b. Weight gain
c. Tinnitus
d. Positive Trendelenburg sign.
8. A nurse is assessing a newborn’s heart rate. Which of the following
actions shouldthe nurse take?
a. Assess the apical pulse is most accurate when the newborn is in a quiet
state. The soundof crying obscures the heart sounds.
b. Palpate the radial pulse for 30 seconds.
c. Listen to the apical pulse while palpating the
radial pulse.d. Auscultate the apical pulse at least
1 min.
9. A nurse is preparing to assist with a thoracentesis for a client who has
pleurisy. Thenurse should plan to perform which of the following
actions?
a. Administer a bowel preparation the night before the procedure.
b. Place the client on bed rest for 24 hr after the procedure.
c. Perform pulmonary function tests following the
procedure.d. Instruct the client to avoid coughing
during the procedure.
10.A nurse in the emergency department is assessing a preschooler who
has a facial laceration. The nurse should identify which of the following
findings as a potentialindication of child sexual abuse?