All practice questions

A medical-surgical nurse is providing discharge education to a 58-year-old client recently diagnosed with stage II chronic kidney disease and essential hypertension. The client asks the nurse for strategies to manage the new diagnoses and prevent further renal damage. To correctly implement a tertiary disease prevention strategy, what specific instruction must the nurse provide?

During a clinic visit, a client reports continuous, severe vomiting over the last two days due to a gastrointestinal illness. The nurse anticipates that this prolonged loss of gastric secretions places the client at highest risk for which acid-base imbalance?

A $35$-year-old client is $6$ hours post-operative following an open reduction and internal fixation (ORIF) of a severe pelvic fracture. The client is receiving a continuous epidural infusion of bupivacaine and fentanyl. The nurse collects the following assessment data:

Which of the following actions should the nurse perform immediately to reduce the risk of further physiological deterioration?

A pediatric clinic nurse is developing a self-care management plan for a 6-year-old client recently diagnosed with moderate persistent asthma. The nurse is discussing daily routines and responsibilities with the child and their parents. Which instruction best promotes appropriate self-care competency for this client?

A registered nurse is caring for an older adult client with cognitive impairment who is receiving continuous enteral feeding via a percutaneous endoscopic gastrostomy (PEG) tube. The client is increasingly restless, frequently scratching at the peri-stomal skin, and attempting to pull the feeding tubing. Which of the following actions is the most appropriate for the nurse to implement?

An adult client experiencing recurrent seizure activity is admitted to the neurological unit. The client has a single patent $20$-gauge peripheral intravenous catheter infusing $5\%$ dextrose in $0.45\%$ sodium chloride at $80 \text{ mL/hr}$. The provider prescribes a stat loading dose of phenytoin $1000 \text{ mg}$ intravenously. The pharmacy delivers the medication diluted in $100 \text{ mL}$ of normal saline. What is the safest method for the nurse to administer this medication?

A nurse is educating a client who has a right fractured tibia and is prescribed non-weight-bearing status. The client is learning to ascend a flight of stairs using axillary crutches. In what order should the nurse instruct the client to perform the following movements?

The interdisciplinary team is managing a client's induced labor. Analysis of the continuous electronic fetal tracing reveals a baseline heart rate of 155 bpm with minimal variability. The nurse notes a pattern of gradual, symmetrical decreases in the fetal heart rate where the onset, nadir, and recovery of each deceleration occur after the beginning, peak, and end of the respective uterine contractions. Given these findings, which of the following immediate actions must the nurse implement? Select all that apply.

A community health nurse is developing a comprehensive self-care and health maintenance plan for an 84-year-old client with mild cognitive decline who lives with family. Which actions by the nurse are appropriate? Select all that apply.

A nurse practitioner is completing a comprehensive health evaluation for a 79-year-old client in an outpatient clinic. The client mentions various physical adaptations they have noticed over the past year. Which client statement requires further investigation because it represents an abnormal disease process rather than a typical physiological change of aging?

An orthopedic unit nurse is evaluating a client 36 hours after a closed reduction and intramedullary nailing of a right femoral shaft fracture. The client suddenly exhibits profound agitation, dyspnea, and a feeling of impending doom. Physical assessment reveals a petechial rash on the anterior chest, distended neck veins, and severe diaphoresis. Vital signs are: blood pressure 86/52 mm Hg, heart rate 134 bpm, respiratory rate 36/min, and SpO2 84% on room air. Arterial blood gas (ABG) analysis indicates a pH of 7.54, PaCO2 of 25 mm Hg, HCO3 of 22 mEq/L, and PaO2 of 52 mm Hg. Based on this clinical presentation, which action should the nurse perform immediately?

A nurse is conducting a comprehensive admission assessment for an 82-year-old client on a medical-surgical unit. Which of the following assessment findings should the nurse interpret as expected age-related physiological changes? Select all that apply.

A nurse is preparing to administer an intravenous (IV) push medication through a Y-site port on a client's active continuous IV infusion line. Which of the following is the priority nursing action before proceeding with the administration?

A client diagnosed with severe sepsis has a double-lumen central venous catheter (CVC). The proximal lumen is dedicated to a continuous infusion of total parenteral nutrition (TPN). The distal lumen is delivering a continuous infusion of norepinephrine to maintain systemic vascular resistance. During the shift, the client's mean arterial pressure drops to $54\text{ mm Hg}$. The provider verbally prescribes an immediate $500\text{ mL}$ intravenous bolus of lactated Ringer's solution and $100\text{ mg}$ of hydrocortisone sodium succinate via intravenous push. Which action by the nurse demonstrates the safest administration of these prescribed therapies?

A registered nurse is planning care for a 78-year-old client who is 1 day post-operative following a right total hip arthroplasty (posterior approach). Which basic care and comfort interventions should the nurse include in the client's plan of care? Select all that apply.

A client arrives at the cardiac step-down unit after a diagnostic cardiac catheterization accessed through the right femoral artery. Which intervention must the nurse implement to reduce the risk of hemorrhage at the access site?

A gerontological nurse is reviewing intake health records at a community senior center. Which client finding should the nurse recognize as an expected physiological adaptation of aging?

A home care nurse is evaluating the self-care management of an older adult client recovering from a right total hip arthroplasty (posterior approach). Which action or statement by the client indicates an accurate understanding of their self-care instructions?

A $28$-year-old client is admitted to the intensive care unit following a high-speed motor vehicle collision. The client sustained a severe pelvic fracture and a right-sided pulmonary contusion. The client is intubated, mechanically ventilated, and sedated. The nurse evaluates the following clinical data:

Which of the following interventions should the nurse implement to mitigate the risk of severe physiological deterioration? (Select all that apply.)

A bedside liver biopsy has just been completed for a client on the medical-surgical unit. Which position should the nurse assist the client into immediately after the procedure to minimize the risk of hemorrhage from the puncture site?