All practice questions

The healthcare provider prescribes a continuous intravenous (IV) infusion of sodium nitroprusside at $2 \text{ mcg/kg/min}$ for a client experiencing a hypertensive emergency. The client's documented weight is $78 \text{ kg}$. The available medication is a $250 \text{ mL}$ bag of $5\% \text{ dextrose in water}$ containing $50 \text{ mg}$ of sodium nitroprusside. At what rate, in $\text{mL/hr}$, should the nurse set the infusion pump? Record your answer rounded to the nearest whole number.

An 82-year-old client with a history of vascular dementia is receiving continuous enteral nutrition through a nasoenteric tube. The client becomes acutely restless, repeatedly attempts to swing their legs over the edge of the bed, and pulls at the nasal tubing. Which action should the registered nurse take first?

A 68-year-old client with a history of chronic obstructive pulmonary disease (COPD) is admitted to the cardiac intensive care unit following a percutaneous coronary intervention (PCI) with stent placement via the right femoral artery. The client is receiving a continuous intravenous heparin infusion and a glycoprotein IIb/IIIa inhibitor. To reduce the risk of severe, life-threatening complications, which of the following assessment findings would require the nurse to intervene immediately? (Select all that apply.)

The nursing team is developing a care plan for an older adult resident in an extended care facility who reports frequent nighttime awakenings and daytime fatigue. Which nursing intervention is most appropriate to promote healthy sleep patterns for this resident?

A primary care clinic nurse is discussing lifestyle choices with a 68-year-old client. The client states, "I recently stopped my daily walks because sudden confusion and severe fatigue are just normal parts of getting older. Also, I have started drinking three glasses of wine each night to help me sleep." Which response by the nurse is the most appropriate?

A nurse is caring for a $58$-year-old client who is $12$ hours post-operative following a partial gastrectomy and Billroth II anastomosis. The client has a nasogastric (NG) tube set to low continuous wall suction and is receiving continuous total parenteral nutrition (TPN) via a central venous catheter. Which of the following assessment findings or planned nursing actions indicate an increased risk for complications and require immediate intervention? Select all that apply.

A 72-year-old client is admitted to the intensive care unit following an endovascular aneurysm repair (EVAR) for an abdominal aortic aneurysm. The procedure was performed via bilateral femoral artery access. The nurse is performing a continuous post-procedure assessment. Which of the following clinical findings indicate a potential complication that requires IMMEDIATE intervention? (Select all that apply.)

A nurse finds a conscious client who has diabetes mellitus profusely sweating and reporting tremors and palpitations. Arrange the following nursing actions in the priority order they should be performed.

A pediatric client with neuroblastoma is scheduled to receive a cyclophosphamide infusion. The client's height is $144 \text{ cm}$ and weight is $36 \text{ kg}$. The provider prescribes cyclophosphamide $825 \text{ mg/m}^2$ IV to infuse continuously over $4 \text{ hours}$. The Mosteller formula for calculating Body Surface Area (BSA) is provided: $\text{BSA (m}^2) = \sqrt{\frac{\text{Height (cm)} \times \text{Weight (kg)}}{3600}}$. The pharmacy dispenses reconstituted cyclophosphamide with a concentration of $20 \text{ mg/mL}$. The nurse must draw up the prescribed dose and inject it into a $150 \text{ mL}$ bag of $0.9\%$ sodium chloride for administration.

What should the nurse set the intravenous infusion pump rate to in mL/hr? (Round the final answer to the nearest tenth.)

An adult client is brought to the emergency department by friends after consuming large amounts of alcohol over the past few days. The client is lethargic, exhibits severe ataxia, and has slurred speech. The healthcare provider has prescribed several interventions. Order the nursing actions from first to last to ensure safe and effective care.

An emergency department nurse is evaluating a client who presented 45 minutes ago with a severe asthma exacerbation. Initially, the client exhibited profound expiratory wheezing, use of accessory muscles, and a respiratory rate of 34 breaths per minute. Currently, the nurse notes that the client is becoming increasingly lethargic, the respiratory rate has decreased to 14 breaths per minute, and breath sounds are notably diminished bilaterally. An arterial blood gas (ABG) analysis reveals a pH of 7.29, PaCO2 of 54 mm Hg, HCO3 of 24 mEq/L, and PaO2 of 62 mm Hg. Which of the following is the most appropriate interpretation and corresponding priority action?

A nurse is teaching a client who has a non-weight-bearing cast on the right lower extremity how to ascend stairs using crutches. Arrange the following actions in the correct chronological order.

A client is admitted to the medical-surgical unit and is receiving a continuous intravenous (IV) infusion of $5\%$ dextrose in water (D5W) at $75 \text{ mL/hr}$. To manage newly developed focal seizure activity, the healthcare provider prescribes a stat dose of phenytoin $100 \text{ mg}$ IV push. Which action by the nurse is the most appropriate?

A nurse is evaluating a client who was recently admitted with a diagnosis of diabetic ketoacidosis (DKA). The nurse draws an arterial blood gas (ABG) sample to assess the client's acid-base balance. Which of the following ABG findings are consistent with the primary acid-base disturbance and the expected physiological compensation for this condition? Select all that apply.

A nurse is caring for a client who was admitted with a massive pulmonary embolism and is receiving a continuous intravenous heparin infusion. The client is now difficult to arouse. Current assessment findings include: blood pressure 82/48 mm Hg, heart rate 134 beats/minute and thready, and respiratory rate 28/minute. The client's skin is cold and diaphoretic. The central venous pressure (CVP) reading is 15 mm Hg (normal: 2 to 8 mm Hg), and urine output was 10 mL over the last hour. Which of the following prescribed interventions should the nurse prioritize?

During a morning rounding shift on a progressive care unit, the nurse evaluates a 76-year-old client admitted for observation after a mechanical fall. When reviewing the client's clinical data, which finding represents a normal physiological consequence of the aging process?

During a home wellness visit, a nurse is updating the care plan for a 68-year-old client with a history of bilateral knee osteoarthritis. The nurse is focusing on integrating disease prevention principles into the client's daily routine. Which of the following nursing actions correctly demonstrates a primary prevention strategy?

A nurse is caring for a client who has been receiving continuous nasogastric (NG) tube suctioning for the past 48 hours. The nurse reviews the client's most recent arterial blood gas (ABG) results:

Based on these results, which acid-base imbalance is the client experiencing?

A nurse is planning basic care for an older adult client who has limited mobility and is experiencing new-onset urinary incontinence. Which of the following interventions should the nurse include in the client's plan of care? Select all that apply.

A nurse is preparing to administer several intravenous (IV) medications to a client who has a continuous primary IV infusion. Which of the following actions demonstrate safe principles of parenteral medication administration? (Select all that apply.)