All practice questions

A client admitted with cardiogenic shock is prescribed a continuous intravenous (IV) infusion of dopamine at $5 \text{ mcg/kg/min}$. The client weighs $176 \text{ lbs}$. The pharmacy provides dopamine $400 \text{ mg}$ mixed in $250 \text{ mL}$ of $0.9\% \text{ NaCl}$.

At what rate in $\text{mL/hr}$ should the nurse program the IV infusion pump? Record your answer as a whole number.

A nurse is caring for a client who was admitted with severe pneumonia and dehydration. The client has a double-lumen central venous catheter, is receiving a continuous infusion of 0.9% sodium chloride, and has new prescriptions for scheduled IV levofloxacin and PRN IV morphine. Which of the following actions by the nurse demonstrate safe parenteral therapy practices? Select all that apply.

An oncology nurse is coordinating shift activities for a group of clients. The care team includes the nurse and an unlicensed assistive personnel (UAP). Which of the following tasks can the nurse safely delegate to the UAP? Select all that apply.

A nurse is performing a sterile vaginal examination on a client in active labor who has just experienced a spontaneous rupture of membranes. The nurse palpates a soft, pulsating mass in the vaginal vault. The electronic fetal monitor demonstrates severe, recurrent variable decelerations. Arrange the following nursing actions in the priority order they should be performed.

An older adult client is recovering on the medical-surgical unit following an ischemic stroke. The nurse observes the client coughing frequently and pocketing food in their cheek during breakfast. Which action should the nurse take to provide safe, collaborative care?

While coordinating care in an outpatient pulmonary clinic, the nurse distributes tasks among the healthcare team. Which client care activity is most appropriate to delegate to the unlicensed assistive personnel (UAP)?

A nurse is independently discontinuing a right subclavian central venous catheter for a 64-year-old client recovering from severe pneumonia. Immediately upon removal of the catheter, the client gasps, becomes intensely diaphoretic, and reports crushing chest pain. Suspecting a central line-associated air embolism, in what order should the nurse perform the following interventions? Arrange from first action to last.

While responding to a high-pressure equipment alarm on a respiratory step-down unit, the charge nurse enters a client's room and observes a float registered nurse (RN) from the psychiatric unit attempting to silence a continuous positive airway pressure (CPAP) machine. The client is visibly dyspneic, diaphoretic, and has not yet been assessed by the float RN. Arrange the following actions the charge nurse should take in the correct priority order.

A registered nurse is preparing to witness the signature on an informed consent document for an older adult client scheduled for a cardiac procedure. The client is alert and oriented but states, 'The physician explained the surgery, but I still do not understand what my other treatment options are. I am only signing this because my daughter said she will stop taking care of me if I refuse.' Which of the following actions should the nurse take? Select all that apply.

A clinical nurse is managing a client admitted with severe acute pyelonephritis. The client suddenly develops new-onset restlessness and confusion. Assessment reveals bounding peripheral pulses, warm and flushed skin, and the following vital signs: temperature $39.2^\circ\text{C}$ ($102.6^\circ\text{F}$), heart rate $128$ beats/minute, respiratory rate $30$ breaths/minute, and blood pressure $86/50\text{ mm Hg}$. An arterial blood gas (ABG) sample drawn on room air demonstrates a pH of $7.50$, PaCO $_2$ of $26\text{ mm Hg}$, PaO $_2$ of $82\text{ mm Hg}$, and HCO $_3^-$ of $21\text{ mEq/L}$. Based on this clinical picture, what is the most critical immediate action the nurse should execute?

During the initial $12$ hours following a transsphenoidal hypophysectomy for a pituitary adenoma, the nurse evaluates a $45$-year-old client's clinical status. Which assessment findings indicate impending physiological decompensation and require immediate risk reduction interventions? (Select all that apply)

A nurse is performing an assessment on a client who is 1 hour postpartum following a spontaneous vaginal birth. The nurse observes a sudden, heavy gush of vaginal bleeding. Upon palpation, the uterus is boggy and displaced to the right of the umbilicus. Arrange the following nursing interventions in the priority order of execution.

A 45-year-old client is receiving continuous mechanical ventilation in the intensive care unit following a severe traumatic brain injury. The client's current intracranial pressure (ICP) reads 24 mmHg. The nurse reviews the most recent assessment data:

- Neurological: Sedated; pupils are equal but sluggish to react.
- Hemodynamics: Blood pressure 170/86 mmHg, heart rate 54 bpm, temperature 37.4°C (99.3°F).
- Arterial Blood Gas (ABG): pH 7.31, PaCO2 56 mmHg, HCO3 25 mEq/L, PaO2 94 mmHg.
- Positioning: Head of the bed elevated at 30 degrees, neck in neutral midline alignment.

To reduce the risk of cerebral herniation, which action should the nurse implement first?

Following a transition of care report, the nurse assesses an older adult hospitalized for an acute infective exacerbation of emphysema. The client is receiving scheduled intravenous glucocorticoids and continuous nebulized bronchodilators. Which of the following clinical findings demand immediate medical notification? Select all that apply.

A nurse is assessing a client who is receiving a continuous peripheral intravenous (IV) infusion of norepinephrine. The nurse notes that the IV insertion site is blanched, cool to the touch, and swollen. The client reports a severe burning sensation at the site. Arrange the following nursing actions in the exact sequence they should be performed, from first to last.

A nurse is preparing to mix and administer regular insulin and NPH insulin in a single syringe for a client with diabetes mellitus. Arrange the following steps in the correct chronological order to ensure safe and effective medication preparation.

A nurse is caring for an older adult client who is 3 hours post-percutaneous coronary intervention (PCI) via a right femoral artery approach. The client, who has a history of osteoarthritis, reports severe lower back stiffness and requests to sit upright or get out of bed. Which intervention should the nurse implement to promote comfort while ensuring client safety?

A client with a seizure disorder is currently receiving a continuous infusion of 5% dextrose in water (D5W) through a single peripheral IV catheter. The healthcare provider prescribes an immediate dose of intravenous phenytoin. Knowing that phenytoin forms a precipitate when mixed with dextrose solutions, arrange the following nursing actions in the correct chronological sequence to safely deliver the medication.

A client with acute kidney injury is exhibiting profound muscle weakness. The bedside cardiac monitor suddenly displays a widened QRS complex and tall, peaked T waves. The laboratory reports a stat serum potassium level of $7.8\text{ mEq/L}$. The healthcare provider has prescribed several urgent interventions. Arrange the following pharmacological actions in the priority sequence the nurse must implement them.

During the morning shift, a nurse provides care for a client who underwent a right above-the-knee amputation 48 hours ago. The client is medically stable and preparing to begin physical therapy. To promote optimal physical mobility and prevent common musculoskeletal complications, which intervention should the nurse implement?