All practice questions

A client admitted with severe sepsis is receiving a continuous intravenous (IV) infusion of piperacillin/tazobactam through a peripheral IV catheter. The healthcare provider prescribes a scheduled dose of IV vancomycin $1,500\text{ mg}$. The pharmacy dispenses the vancomycin in a $300\text{ mL}$ bag of $0.9\%$ sodium chloride. Institutional protocol requires vancomycin doses greater than $1,000\text{ mg}$ to be infused over a minimum of $90\text{ minutes}$ to prevent adverse infusion reactions. The client has only one patent peripheral IV line. Which of the following is the most appropriate nursing action?

During the management of a critically ill adult in the intensive care unit, a triple-lumen central venous catheter (CVC) is utilized for multiple continuous infusions. The client's distal lumen is infusing epinephrine to maintain hemodynamic stability, the medial lumen is reserved for continuous total parenteral nutrition (TPN), and the proximal lumen is delivering a standard heparin protocol. Suddenly, the cardiac monitor displays symptomatic supraventricular tachycardia (SVT), and the healthcare provider prescribes an immediate dose of adenosine via rapid intravenous push. Which parenteral administration technique represents the safest clinical judgment?

A client is receiving a high therapeutic dose of radioactive iodine (I-131) for the treatment of thyroid cancer. A few hours after the dose is administered, the client accidentally spills a large amount of urine on the hospital room floor. Which action should the nurse take first?

A nurse is preparing to provide a bed bath and perineal care for a client who is receiving continuous enteral nutrition via a nasogastric tube. The procedure requires lowering the head of the bed to a flat, supine position. Which of the following is the priority action for the nurse to take?

A public health nurse is utilizing the Transtheoretical Model of Change to counsel a client regarding smoking cessation. Arrange the following nursing interventions in the chronological order that they should be implemented as the client progresses through the stages of change, from earliest to latest.

A registered nurse is preparing to administer a prescribed intravenous (IV) loading dose of phenytoin to an adult client experiencing recurrent generalized seizures. Which of the following nursing actions are necessary during the preparation and administration of this parenteral medication? (Select all that apply.)

The registered nurse (RN) receives the morning shift report for a group of clients on a medical-surgical unit. Which client should the nurse assess first?

An occupational health nurse is evaluating an employee who reports chronic headaches, recent-onset insomnia, and frequent irritability. The employee states, 'My workload has doubled over the last three months, and I feel like I am completely failing at my job and my life.' Which action should the nurse take first?

An occupational health nurse is conducting an annual wellness assessment for a 52-year-old client. According to Erikson's theory of psychosocial development, which statements by the client indicate successful mastery of the primary developmental task for this age group? Select all that apply.

A nurse is closely monitoring a client who is 4 hours postoperative following an open abdominal surgery. Which of the following assessment findings should the nurse recognize as early indicators of impending hemorrhagic shock? Select all that apply.

A registered nurse is preparing to access a client's implanted venous access port (Port-a-Cath) to administer a scheduled intravenous infusion. Arrange the following steps in the correct chronological order to safely perform this procedure.

During a care conference, the parents of a 22-year-old client with newly diagnosed advanced lymphoma request that the healthcare team withhold the full prognosis to protect the client from emotional distress. The client is cognitively intact and has explicitly asked the nurse for complete transparency regarding the illness. Which nursing actions appropriately address this family conflict? Select all that apply.

An 82-year-old client is accompanied by their adult child to a primary health consultation. The child expresses concern regarding several physical changes observed since the client relocated to the child's home. The evaluating nurse must distinguish between typical senescence and indications of pathological disease. Which of the following assessment findings represent expected physiological adaptations of the aging process? Select all that apply.

An adult client with symptomatic anemia is scheduled to receive a transfusion of packed red blood cells. The healthcare provider has prescribed the blood product to be infused over two hours. Which of the following intravenous fluids must the nurse select to prime the blood administration tubing?

A client has just arrived on the medical unit after undergoing a bedside lumbar puncture. To minimize the risk of developing a cerebrospinal fluid leak and subsequent headache, which of the following positioning interventions should the nurse implement?

A clinic nurse is developing a plan of care for a young adult client who was recently diagnosed with multiple sclerosis. The client reports feeling overwhelmed, experiencing difficulty sleeping, and states, 'I feel like I have absolutely no control over my life or my future anymore.' Which of the following nursing interventions are appropriate to promote effective stress management? Select all that apply.

A maternity clinic nurse is conducting an initial prenatal visit for a client at 8 weeks gestation. The client confides, "I usually drink heavily on the weekends, and I had a few episodes of binge drinking before I knew I was pregnant. I am terrified that I have already caused permanent harm to my baby." Which response by the nurse is the most appropriate?

A nurse is administering an intramuscular injection to a client and sustains a percutaneous needlestick injury from the used needle. Arrange the following actions the nurse should take in the correct order of priority.

The nurse is reviewing the care plan for a client who is 48 hours postoperative following a right below-the-knee amputation. Which interventions are appropriate to include in the client's basic care and comfort management? Select all that apply.

A registered nurse in the cardiovascular intensive care unit is caring for a client with severe decompensated heart failure.

Client data:
- Weight: $176\text{ lb}$
- Current cardiac index (CI): $1.8\text{ L/min/m}^2$
- Current dobutamine infusion rate: $12\text{ mL/hr}$
- Intravenous fluid bag: Dobutamine $500\text{ mg}$ in $250\text{ mL}$ of $5\%\text{ Dextrose in Water (D5W)}$

The unit's hemodynamic titration protocol states: "If CI is $< 2.0\text{ L/min/m}^2$, increase dobutamine infusion by $2.5\text{ mcg/kg/min}$ every 30 minutes until CI is $\geq 2.0\text{ L/min/m}^2$. Maximum dose: $20\text{ mcg/kg/min}$."

The nurse evaluates the client's current status and determines a titration is required. Based on the protocol, what should the nurse set the new infusion rate to in $\text{mL/hr}$? Record your answer to the nearest whole number.