Exam (elaborations)
Passpoint Review (1).
Passpoint Review (1).
[Show more]
Seller
Follow
Content preview
Passpoint ReviewThe nurse is caring for a client during the first 72 hours after thyroidectomy. The
nurse should assess for which signs of complications of this surgery? - CORRECT
ANSWER-carpal spasms and facial numbness
A client is seen in the clinic for newly diagnosed hypothyroidism. Which topics
should the nurse include in a client teaching plan? Select all that apply. - CORRECT
ANSWER--high-fiber, low-calorie diet
-use of stool softeners
-thyroid hormone replacements
A nurse is caring for a client who is disoriented to time, place, and person and is
attempting to get out of bed and pull out an intravenous line. The nurse receives
orders from a health care provider to apply a vest restraint and bilateral soft wrist
restraints. In carrying out this order, which nursing actions would be appropriate?
Select all that apply. - CORRECT ANSWER--Perform a face-to-face behavior
evaluation every hour.
-Tie the restraints in quick-release knots.
-Document the client's condition.
-Document alternative methods used before the restraints were applied.
-Document the client's response to the intervention.
A school-age child with glomerulonephritis reports a headache and blurred vision.
What immediate action should the nurse take? - CORRECT ANSWER-Obtain the
child's blood pressure.
A client is placed on hypocalcemia precautions after removal of the parathyroid
gland for cancer. The nurse should observe the client for which symptoms? Select
all that apply. - CORRECT ANSWER--numbness
-tingling
-muscle twitching and spasms
A 35-year-old client is brought to the emergency department with second- and
third-degree burns over 15% of the body. Admission vital signs are blood pressure
100/50 mm Hg, heart rate 130 beats/minute, and respiratory rate 26 breaths/minute.
Which nursing interventions are appropriate for this client? Select all that apply. -
CORRECT ANSWER--Begin an intravenous (I.V.) infusion of lactated Ringer's
solution.
-Administer 6 mg of IV morphine.
-Administer tetanus prophylaxis, as ordered.
,The nurse is caring for a client with a serum sodium level of 128 mEq/L. Which order
for intravenous fluids should the nurse should question? - CORRECT
ANSWER-dextrose 5% in water (D5W)
A client has a tumor of the posterior pituitary gland. The nurse planning the client's
care would include which interventions? Select all that apply. - CORRECT
ANSWER--Weigh the client daily.
-Measure urine specific gravity.
-Monitor intake and output.
A client undergoes a nephrectomy. In the immediate postoperative period, which
nursing intervention has the highest priority? - CORRECT ANSWER-Assess urine
output hourly.
An elderly client has been admitted to the medical-surgical unit from the
postanesthesia care unit. While the nurse is off the floor, the client falls out of bed
and fractures the right leg and right wrist. The nurse finding the client states, "The
side rails were down and the bed was in the high position." The client's family files
legal charges against the nurse and the hospital. Which charge most accurately
reflects the nurse's actions? - CORRECT ANSWER-negligence
A nurse is preparing to administer a unit of blood to a client with anemia. After its
removal from the refrigerator, the blood should be administered within: - CORRECT
ANSWER-4 hours.
In the emergency department, a client reveals to the nurse a lethal plan for dying by
suicide and agrees to a voluntary admission to the psychiatric unit. Which
information would the nurse discuss with the client to answer the question "How long
do I have to stay here?" Select all that apply. - CORRECT ANSWER--"You may
leave the hospital at any time unless you're suicidal or homicidal or unable to meet
your basic needs."
-"Let's talk after the health care team has assessed you."
-"Because you have stated that you want to hurt yourself, you must be safe before
being discharged."
Which should be the nursing priority of care for a client exhibiting signs and
symptoms of coronary artery disease? - CORRECT ANSWER-enhance myocardial
oxygenation
Which client has a need for prophylactic antibiotic therapy prior to dental
manipulations? - CORRECT ANSWER-the client who had an aortic valve
replacement 5 years ago
, The nurse is caring for a client that has a low potassium level. What medication(s)
would the nurse be concerned about administering to this client? Select all that
apply. - CORRECT ANSWER--digoxin
-furosemide
The nurse is caring for a client with a gastrostomy tube. Fifteen minutes after a
bolus feeding the client experiences bloating, cramping, diarrhea, dizziness,
diaphoresis, and weakness. What action should the nurse take? - CORRECT
ANSWER-Contact the healthcare provider to alter the enteral feeding prescription.
Following a transurethral resection of the prostate (TURP), a client is receiving a
normal saline 0.9% irrigation solution at 200 mL/hour. The client has a peripheral IV
running at 125 mL/hour and has consumed 300 mL of water. After 8 hours, the
nurse empties 3100 mL of fluid from the Foley bag. What is the 8-hour urinary
output for this client? Record the answer as a whole number. - CORRECT
ANSWER-1500
The nurse should monitor the client with acute pancreatitis for which complication? -
CORRECT ANSWER-pneumonia
Which safety measures would be most important to implement when caring for a
client who is receiving 2 units of packed red blood cells (PRBCs)? Select all that
apply. - CORRECT ANSWER--Infuse a unit of PRBCs in less than 4 hours.
-Stop the transfusion if a reaction occurs, but keep the line open.
-Inspect the blood bag for leaks, abnormal color, and clots.
The nurse is developing a care management plan with a client who has been
diagnosed with gastroesophageal reflux disease. What should the nurse instruct the
client to do? Select all that apply. - CORRECT ANSWER--Avoid a diet high in fatty
foods.
-Avoid beverages that contain caffeine.
-Avoid all alcoholic beverages.
A nurse has a four-patient assignment in the medical step-down unit. When planning
care for the clients, which client would have the following treatment goals: fluid
replacement, vasopressin replacement, and correction of underlying intracranial
pathology? - CORRECT ANSWER-the client with diabetes insipidus
The nurse and parents plan for the discharge of a child with leukemia who is
receiving dactinomycin and vincristine. Which intervention should the nurse include
in the teaching plan? - CORRECT ANSWER-Encourage increased fluid intake.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller lydiaomutho. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for CA$11.24. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
79064 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now