All practice questions

An older adult client is transferred to the medical-surgical unit after a cardiac catheterization accessed via the right femoral artery. The client is on bed rest, has a history of osteoarthritis, and reports generalized back stiffness. Which of the following nursing actions should be included in the client's basic care and comfort plan? Select all that apply.

An adult weighing $176\text{ lb}$ requires vasopressor support for septic shock. The critical care provider prescribes a norepinephrine infusion to begin at $0.05\text{ mcg/kg/min}$. The available IV bag contains $4\text{ mg}$ of norepinephrine mixed in $250\text{ mL}$ of $5\%$ dextrose in water (D5W). At how many $\text{mL/hr}$ will the infusion pump run? Record your answer using a whole number.

A registered nurse is conducting an interdepartmental handoff using the SBAR (Situation, Background, Assessment, Recommendation) framework for a 26-year-old client transferring to an acute neuro-rehabilitation unit following a severe traumatic brain injury. During the 'Recommendation' phase, the nurse outlines the necessary interprofessional team involvement. The client has a healing tracheostomy, receives continuous enteral nutrition, exhibits frequent episodes of psychomotor agitation, and requires total assistance with activities of daily living. The family is profoundly overwhelmed by the uncertain prognosis. Which of the following recommendations should the nurse include to ensure appropriate collaborative care and safe management? (Select all that apply)

The intensive care unit nurse is caring for an unresponsive client with end-stage multi-organ failure. The client's spouse, who is the legally designated durable power of attorney for healthcare (DPOA), directs the medical team to withdraw mechanical ventilation according to the client's previously expressed wishes. A sibling of the client angrily objects, threatens a malpractice lawsuit, and demands that all life-sustaining measures continue. Which actions by the nurse demonstrate adherence to ethical and legal nursing principles? Select all that apply.

A client with metastatic pancreatic cancer is preparing for discharge to home hospice care. The client has severe cachexia, requires maximum assistance with bathing due to profound weakness, and expresses deep spiritual distress about the end of life. The client's spouse feels overwhelmed and states they cannot physically manage the demands of providing daily hygiene care. Which action by the nurse demonstrates the most appropriate interdisciplinary collaboration?

A 68-year-old client is preparing for discharge home following a complex bowel resection with a new permanent colostomy. The client has a history of poorly controlled type 2 diabetes mellitus with severe peripheral neuropathy in both hands. The client expresses significant concern about the cost of ostomy supplies and insulin. Which of the following interdisciplinary team collaborations should the registered nurse initiate? Select all that apply.

During a morning shift, a nurse is assigned to care for a client who has a confirmed diagnosis of active pulmonary tuberculosis alongside a large, draining sacral pressure injury infected with methicillin-resistant Staphylococcus aureus (MRSA). Which of the following infection control interventions should the nurse implement? Select all that apply.

An adult client hospitalized with rapid atrial fibrillation is receiving a continuous intravenous (IV) infusion of diltiazem to maintain ventricular rate control. The client has a single peripheral IV catheter located in the left forearm. The healthcare provider prescribes a scheduled dose of intravenous pantoprazole. The nurse consults the facility's pharmacology reference and notes that pantoprazole is physically incompatible with diltiazem. Which action should the nurse take to safely administer the prescribed medication?

An older adult client with acute delirium secondary to urosepsis is repeatedly grasping at their central venous catheter. The nurse must implement safety measures to prevent line dislodgement. Arrange the following interventions in the correct order of implementation, from the first initial action (least restrictive) to the final emergency measure (most restrictive).

A nurse is caring for a client with a history of adrenal insufficiency who was admitted for management of severe gastroenteritis. During the most recent assessment, the client appears increasingly lethargic. Vital signs show the heart rate has trended from $82$ to $114 \text{ beats/min}$, and the blood pressure has shifted from $118/76 \text{ mm Hg}$ to $102/84 \text{ mm Hg}$. Current laboratory results indicate a serum sodium of $131 \text{ mEq/L}$ ($131 \text{ mmol/L}$), serum potassium of $5.8 \text{ mEq/L}$ ($5.8 \text{ mmol/L}$), and an arterial blood gas (ABG) revealing a $\text{pH}$ of $7.31$, $\text{PaCO}_2$ of $36 \text{ mm Hg}$, and $\text{HCO}_3^-$ of $18 \text{ mEq/L}$ ($18 \text{ mmol/L}$). Which of the following is the priority nursing intervention?

An orthopedic unit nurse assumes care of a client who underwent a right above-the-knee amputation (AKA) twenty-four hours ago. The client's vital signs are currently stable, but they remain at high risk for physiological complications that could impede future rehabilitation. Which of the following nursing actions is most appropriate to reduce the client's risk of adverse physiological outcomes?

Following the morning handoff report on a maternity postpartum unit, a registered nurse must prioritize client assessments. In what order should the nurse assess the following clients? Arrange the clients from highest priority to lowest priority.

A healthcare provider prescribes an intravenous piggyback (IVPB) infusion of cefazolin 1 gram in $50\text{ mL}$ of 0.9% sodium chloride to be administered over $30\text{ minutes}$. The nurse should set the intravenous infusion pump to deliver how many $\text{mL/hr}$? Record your answer using a whole number.

During the night shift, a nurse is monitoring a client admitted with acute decompensated heart failure and rapid atrial fibrillation. The client has a single 22-gauge peripheral intravenous catheter infusing continuous diltiazem. Assessment reveals a blood pressure of 92/60 mmHg, an irregular heart rate of 118 beats/min, and a respiratory rate of 28 breaths/min with audible crackles bilaterally. The provider orders a stat dose of intravenous furosemide. Upon checking the compatibility matrix, the nurse notes that furosemide is physically incompatible with diltiazem. What is the priority nursing action?

An older adult client is bedbound and recovering from severe bacterial pneumonia when they develop sudden, acute agitation and confusion. The nursing team is establishing interventions to address the client's basic care, comfort, and safety needs. Which of the following actions should be included in the care plan? Select all that apply.

A nurse is conducting a comprehensive admission assessment on a 75-year-old client being admitted to a rehabilitation facility following a total hip arthroplasty. Which of the documented assessment findings should the nurse recognize as expected physiological adaptations to the aging process? Select all that apply.

A client on a medical-surgical unit is preparing for an elective colonoscopy. The client, who has age-related hearing loss, is fully oriented. After the gastroenterologist explains the procedure and leaves the room, the nurse enters to witness the informed consent signature. The client hesitates and states, "I did not hear everything the doctor said. I am still confused about what happens if they find a growth." Which action by the nurse is required?

An older adult client with severe osteoarthritis and mild dementia resides in a long-term care facility. During early morning rounds, the client becomes verbally agitated and physically resists when staff attempt to change the bed linens and assist with dressing. Recognizing that joint stiffness is a primary contributing factor, which action should the nurse take?

A registered nurse is conducting rounding and discovers a client, who is receiving a continuous intravenous heparin infusion, lying on the floor next to their bed. The client is conscious but appears disoriented. Arrange the following nursing actions in the correct priority sequence from first to last.

A nursing unit manager is conducting a quality improvement observation of staff members interacting with a client who has frequent, foul-smelling diarrheal stools and a confirmed *Clostridioides difficile* infection. Which observed actions indicate a breach in infection control protocols that requires immediate intervention? (Select all that apply)