1. 1. Following long-term administration of warfarin c. The PT will be
sodium to a client with a medical diagnosis of deep 1.5 times the nor-
vein thrombosis, the nurse should expect which treat- mal
ment?
a. The hemoglobin will be greater than 10 g/dl
b. The hematocrit will be less than 35%
c. The PT will be 1.5 times the normal
d. The PTT will be 1.5 times the normal
2. A client who has been taking finasteride, an en- zyme Urinary retention
(5 alpha reductase) inhibitor used to shrink the
prostate gland, is admitted because of continuing be-
nign prostate prostatic hypertrophy (BPH) symptoms
when planning care. Which nursing problem should
the nurse address first?
3. An older client has been diagnosed with chronic ve- Wear cotton socks
nous insufficiency. To prevent venous return, which and enclosed toe
action should the nurse encourage the client to? shoes whenever
outside
4. When caring for a client with a full thickness burn cov- White blood cell
ering 40% of the body, the nurse observes pertinent (WBC) count
drainage at the wound. Before reporting this finding to
the healthcare provider, the nurse should review
which of the client's laboratory values?
5. An older client arrives at the outpatient eye surgery Provide an eye
clinic for a right cataract extraction and implant. Dur- shield to be worn
ing the immediate postoperative period, which inter- while sleeping
vention should the nurse implement?
6. After several days of coughing and taking aceta- Reassess vital
minophen to treat temperatures of 101 F (38.3 C), a signs
client with DI is admitted to the hospital with an upper
respiratory infection. Several hours after admission,
the client reports having a severe headache and feel-
ing dizzy. Which intervention should the nurse imple-
ment first?
1/9
, 7. A client takes daily supplemental iron tablets for Complete blood
iron deficiency anemia reports feeling increasingly count
fatigued. Which laboratory values should the nurse
review?
8. The nurse is caring for a client post anesthesia care Medicate for pain
unit (PACU) who underwent a thoracotomy twohours and monitor vital
ago. The nurse observes the following vital signs: signs according to
heart rate 140 beats/ minute, respirations 26 protocol
breaths/minute, and blood pressure 140/90 mmHg.
Which intervention is most important for the nurse to
implement?
9. A client who was involved in a motor vehicle collisionis - Verify pedal puls-
admitted with a fractured left femur which is immo- es using a doppler
bilized using a fracture traction splint in preparation pulse device
for an open reduction internal fraction (ORIF). The - Monitor left leg
nurse determines that the client's distal pulses are for pain, pallor,
diminished in the left foot.Which interventions should paresthesia, paral-
the nurse implement? (SATA) ysis, pressured. -
Evaluate the appli-
cation of the splint
to the left leg
10. A nurse is caring for a client with Diabetes Insipidus Serum sodium of
(DI). which data warrants the most immediate inter- 185 mEq/L
vention by the nurse?
11. The nurse assesses a client with petechiae and ec- Platelet count
chymosis scattered across the arms and legs. Which
laboratory result should the nurse review?
12. A male client is admitted to the emergency depart- Insert a NGT and
ment with vomiting of dark brown, foul- smelling eme- attach to low suc-
sis. He reports he had a surgical repair of a recurrent tion
inguinal hernia one week ago and complains of in-
tense abdominal pain. After assessing that his bowel
sounds are hyperactive, which prescription should the
nurse implement first?
2/9
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