All practice questions

A client weighing $76 \text{ kg}$ is receiving a continuous intravenous (IV) infusion of unfractionated heparin for a deep vein thrombosis. The current infusion rate is $16 \text{ units/kg/hr}$. The IV bag is labeled "Heparin sodium $25,000 \text{ units}$ in $500 \text{ mL}$ $0.45\% \text{ NaCl}$". The client's morning activated partial thromboplastin time (aPTT) result is $112 \text{ seconds}$ (reference range: $30-40 \text{ seconds}$).

The facility's heparin titration protocol specifies the following actions based on aPTT results:
- aPTT $71-90 \text{ seconds}$: Decrease infusion rate by $2 \text{ units/kg/hr}$.
- aPTT $> 90 \text{ seconds}$: Stop the infusion for $1$ hour, then decrease the rate by $3 \text{ units/kg/hr}$.

Based on the protocol, which sequence of actions and newly programmed IV pump rate should the nurse implement? (Round the final pump rate to the nearest tenth).

A nurse operating a mobile health clinic in an urban neighborhood is reviewing the scheduled interventions for the day. Which of the following actions best illustrates a primary disease prevention strategy?

A client attending a community-based addiction recovery program states to the nurse, "I know I slipped up and used cocaine this weekend, but my partner has been arguing with me constantly, and I just could not handle the stress." Which response by the nurse is the most therapeutic?

A nurse is planning care for a client who has just returned to the nursing unit following a lumbar puncture. Which of the following actions should the nurse take to reduce the risk of post-procedure complications?

A nurse is preparing to transfer a client who has right-sided weakness from the bed to a wheelchair. Arrange the following nursing actions in the correct sequence to ensure a safe transfer.

A 45-year-old client with acute necrotizing pancreatitis is being monitored in the high-acuity unit. Over a four-hour observation period, the client's serum calcium drops dramatically from 8.8 mg/dL to 6.5 mg/dL, accompanied by a rising heart rate of 118 bpm. The client reports a progressive 'pins and needles' sensation around the mouth and in the fingertips. As an unlicensed assistive personnel (UAP) approaches the bedside and begins wrapping a sphygmomanometer cuff around the client's upper arm, what represents the paramount risk reduction action?

An adult client is receiving care in the emergency department for a severe asthma exacerbation. Following one hour of continuous albuterol nebulization and intravenous corticosteroids, the client's respiratory rate is 32 breaths per minute, and auscultation reveals that the previously loud, bilateral expiratory wheezes are now significantly diminished. The most recent arterial blood gas (ABG) analysis on room air reveals a pH of 7.36, a PaCO2 of 44 mm Hg, and a PaO2 of 61 mm Hg. Which action should the nurse take to reduce the client's immediate risk of physiological deterioration?

A client with short bowel syndrome is receiving continuous total parenteral nutrition (TPN) through a single-lumen central venous catheter. The electronic health record indicates a new prescription for an intermittent intravenous antibiotic. Upon assessment, the nurse notes the client does not have any other established venous access. What is the most appropriate action by the nurse?

A telehealth nurse is consulting with a young adult client who mentions smoking electronic cigarettes and occasional traditional cigarettes. The nurse decides to implement the evidence-based brief intervention framework for tobacco cessation. Arrange the nurse's actions in the correct sequential order.

A registered nurse is caring for a gravid client in active labor when spontaneous rupture of membranes occurs. The fetal heart rate suddenly drops to $80\text{ beats per minute}$, and the nurse visualizes the umbilical cord protruding from the introitus. In what sequence should the nurse perform the following actions? Arrange the interventions from first to last.

A nurse is developing a care plan for a client who is 48 hours postoperative following a right above-the-knee amputation. Which interventions should the nurse include to promote comfort, mobility, and proper positioning? Select all that apply.

An intensive care nurse is caring for a client who is receiving positive pressure mechanical ventilation. The ventilator's high-pressure alarm suddenly sounds, and the client's oxygen saturation drops to 84%. Assessment reveals absent breath sounds over the right lung field, a blood pressure of 82/40 mm Hg, and the trachea deviated toward the left. Which of the following interventions should the nurse anticipate performing immediately?

A nurse is preparing to administer a primary intravenous infusion of $1,000$ mL of $0.9\%$ sodium chloride over $8$ hours. At what rate should the nurse program the electronic infusion pump in mL/hr? (Record your answer as a whole number.)

A rapid response team is called to an inpatient unit for a client who is experiencing a generalized tonic-clonic seizure. The seizure activity has been continuous for 12 minutes without the client regaining consciousness. Upon arrival, the nurse notes circumoral cyanosis and audible gurgling respirations. Arrange the following emergent interventions in the priority sequence they must be executed.

A client with severe gastroenteritis is admitted with a serum potassium level of $2.7 \text{ mEq/L}$ ($2.7 \text{ mmol/L}$). The healthcare provider prescribes an intravenous (IV) infusion of $40 \text{ mEq}$ ($40 \text{ mmol}$) of potassium chloride (KCl) diluted in $250 \text{ mL}$ of $0.9\%$ sodium chloride to be administered via a peripheral intravenous catheter. Which of the following nursing actions are required for the safe administration of this medication? (Select all that apply.)

A nurse is preparing to administer prescribed oral medications to an older adult client who experiences age-related changes in swallowing (presbyphagia). The client reports occasional coughing during meals. In what order should the nurse implement the following interventions to ensure safe medication administration?

A client is admitted to the intensive care unit with severe diabetic ketoacidosis (DKA). The client is lethargic, exhibiting Kussmaul respirations, and has a blood glucose level of 520 mg/dL (28.9 mmol/L). The healthcare provider has entered multiple initial prescriptions. In what order should the nurse perform the following actions? Arrange the interventions in the correct clinical sequence from first to last.

A primary care clinic nurse is applying an evidence-based behavioral intervention framework to promote smoking cessation for a young adult client during a routine wellness visit. In what chronological order should the nurse implement these interventions? Arrange the nursing actions from first to last.

Following the intershift handoff on an acute perinatal care unit, the nursing team must prioritize initial assessments. Based on the presenting clinical data, which client requires the most immediate bedside evaluation?

A nurse is preparing to administer an oral suspension of an antibiotic to a pediatric client who weighs $44 \text{ lb}$. The prescription is for $10 \text{ mg/kg/day}$ to be given in two equally divided doses. The pharmacy dispenses an oral suspension with a concentration of $50 \text{ mg/mL}$. How many milliliters should the nurse administer per dose?