PCC 2 Exam 1 Questions & Answers 2024/2025
When assessing a patient in the hospital setting, the nurse knows which of the following statements to be true? - ANSWERSa consistent, specialized, and focused exam every 8 hours
Which finding would require immediate attention for a patient just ad...
When assessing a patient in the hospital setting, the nurse knows which of the following statements to
be true? - ANSWERSa consistent, specialized, and focused exam every 8 hours
Which finding would require immediate attention for a patient just admitted from ER? - ANSWERSheart
rate of 130 beats per minute
What should the nurse assess before entering the patient's room on morning rounds? - ANSWERSposted
conditions, such as isolation precautions
When assessing the neurologic system of a patient during morning rounds, what should be included? -
ANSWERSpatient's ability to communicate
At the beginning of rounds when entering the room, what should the nurse do first? - ANSWERSmake
eye contact with the patient and introduce myself as the nurse
The nurse is caring for a client who has decreased mobility. Which intervention is a simple and cost-
effective method for reducing the risks of stasis of pulmonary secretions and decreased chest wall
expansion? - ANSWERSfrequent change of position
A nurse is caring for an 89-year-old client admitted with pneumonia. He has an IV of normal saline
running at 100 mL/hr and antibiotics that were initiated in the emergency department 3 hours ago. He
has oxygen at 2 liters/nasal cannula. What assessment finding by the nurse indicates that goals for a
priority diagnosis have been met for this client?
A. The client is alert and oriented to person, place, and time
B. Urine output has been >30 mL/hr per Foley catheter
C. Skin behind the ears demonstrates no redness or irritation
D. Breath sounds with crackles left lower lobes - ANSWERSA
, A client is admitted to the hospital with cough, purulent sputum production, temperature of 100.3, and
reports of dyspnea. Which intervention does the nurse provide first?
A. Evaluate the effectiveness of oxygen therapy (pulse oximetry, ABGs) as appropriate
B. Call the pharmacy to request an IV pump and obtain first dose of antibiotic
C. Monitor the client's anxiety related to the need for oxygen delivery
D. Set up oxygen equipment and administer oxygen. - ANSWERSD
A client is admitted to the hospital for treatment of pneumonia. Which nursing assessment findings best
indicates that the client is responding to antibiotics?
A. Temperature 99 F, lung sounds clear, pulse oximetry on 2L/min at 98%, cough with yellow sputum
B. Wheezing, oxygen at 2 L/min, respiratory rate 26, no dyspnea or chills
C. Feeling tired, respiratory rate 28 on 2 L/min of oxygen, audible breath sounds
D. Cough, clear sputum, temperature 99 F, pulse oximentry at 96% on room air - ANSWERSD
The nurse is reviewing laboratory results for a client who has pneumonia. Which laboratory value does
the nurse expect to see for this client?
A. Elevated creatinine
B. Decreased neutrophils
C. Increased white blood cells (WBC)
D. Increased red blood cells (RBC) - ANSWERSC
What does the nurse expect the chest x-ray results to reveal for a client admitted to the hospital with
pneumonia?
A. Thick secretions causing airway obstructions
B. Large hyperinflated airways
C. Enlarged heart
D. Patchy areas of increased density - ANSWERSD
What is an appropriate technique for the nurse to use when inserting a nasogastric (NG) tube?
A. Measure the tube length from nose to sternum
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