All practice questions

A client with an established gastrostomy tube is scheduled to receive an intermittent bolus feeding. Arrange the following nursing actions in the correct sequential order from first to last.

A 70-year-old client with a history of severe chronic obstructive pulmonary disease (COPD) is hospitalized for treatment of a left lower extremity deep vein thrombosis. The client suddenly develops sharp, pleuritic chest pain, severe dyspnea, and profound apprehension.

Current Assessment and Laboratory Data:
- Vital Signs: BP 94/60 mmHg (baseline 135/82), HR 122 bpm, RR 32/min, Temperature 98.9°F (37.2°C).
- SpO2: 84% on 2 L/min oxygen via nasal cannula.
- Skin: Pale, diaphoretic, with circumoral cyanosis.
- Arterial Blood Gas (ABG):
- pH: 7.54
- PaCO2: 28 mmHg (baseline 55 mmHg)
- HCO3-: 26 mEq/L
- PaO2: 52 mmHg

The nurse suspects an acute pulmonary embolism. To reduce the client's risk for immediate cardiopulmonary collapse, which of the following is the most critical initial action?

A nurse is caring for a young adult client who has just received a diagnosis of HIV. The client is staring at the floor and states in a quiet voice, "I cannot tell my family about this. If they find out, they will completely disown me and I will have no one left." Which of the following is the most therapeutic response by the nurse?

A nurse is initiating a therapeutic interaction with a newly admitted client who has major depressive disorder. The client is sitting alone in the dayroom, appearing withdrawn, and avoiding eye contact. Arrange the following therapeutic communication interventions in the most appropriate sequence, from first to last.

A nurse is caring for a critically ill client who has a double-lumen peripherally inserted central catheter (PICC). Lumen 1 is infusing continuous norepinephrine, and Lumen 2 is infusing 0.9% sodium chloride at a keep-vein-open rate. The healthcare provider prescribes a continuous infusion of pantoprazole, an intermittent IV piggyback of vancomycin, and a STAT dose of IV push furosemide $40\text{ mg}$. The client's total urine output over the past 2 hours is $25\text{ mL}$. Which of the following nursing actions are appropriate? Select all that apply.

A client recovering from a cluster of generalized tonic-clonic seizures has a single 20-gauge peripheral intravenous (IV) catheter in the right forearm. A continuous maintenance infusion of 5% dextrose in 0.45% sodium chloride is currently infusing at 100 mL/hr. The healthcare provider prescribes a loading dose of IV phenytoin to be administered immediately to prevent further seizure activity. Which action is the most appropriate for the nurse to implement?

A client is being monitored on the medical-surgical unit for severe bilateral pneumonia. The most recent arterial blood gas (ABG) results show a pH of 7.31, PaCO2 of 56 mm Hg, and HCO3- of 24 mEq/L. Which of the following assessment findings correlate with this acid-base imbalance? Select all that apply.

The nursing team is providing morning hygiene care for a client who recently sustained a right-sided cerebrovascular accident (CVA). The client presents with left-sided hemiplegia and left homonymous hemianopsia, and is receiving continuous enteral nutrition via a nasogastric (NG) tube. The registered nurse (RN) is providing specific parameters to the unlicensed assistive personnel (UAP) regarding the care routine. Which directive from the RN represents the safest and most comprehensive approach to this client's basic care and comfort?

An adult client requires a morning dose of both short-acting (regular) and intermediate-acting (NPH) insulin. The nurse is drawing up both medications into a single syringe. Place the steps of this preparation process in the correct chronological sequence.

A young adult client recently admitted with a diagnosis of anorexia nervosa is observed pacing rapidly up and down the unit hallway. The client appears severely anxious and tells the nurse, "I had to eat that entire sandwich at lunch, and I can literally feel the fat forming on my thighs. I have to keep moving." Which action should the nurse take?

A clinical charge nurse is evaluating a new graduate nurse who is performing physical assessments on a medical-surgical unit. Which of the following assessment techniques by the new graduate nurse demonstrate correct practice? Select all that apply.

A 22-year-old client with severe right lower quadrant abdominal pain arrives at the emergency department accompanied by a parent. The parent states, "My child understands very little English, so I will translate. In our culture, we prefer to endure pain and use traditional herbal teas rather than taking Western narcotics." The client is grimacing, guarding the abdomen, and avoiding eye contact. Which of the following is the most appropriate action by the nurse?

A nurse is caring for an adult client who is post-operative day one following a right total hip arthroplasty. The client is receiving a continuous intravenous (IV) infusion of $0.9\%$ sodium chloride. The provider has prescribed several new oral and intravenous medications. Which of the following nursing actions demonstrate safe pharmacological and parenteral therapy practices? Select all that apply.

A client with a history of aggressive behavior becomes visibly agitated in the dayroom, pacing rapidly with clenched fists and shouting profanities at peers. Arrange the following nursing interventions in order from the least restrictive to the most restrictive approach.

An oncology registered nurse is preparing to obtain a blood specimen from a client's implanted venous access port. The nurse has gathered all necessary supplies. Arrange the following steps for accessing the port and drawing the blood specimen in the correct chronological sequence.

A nurse in a surgical intensive care unit is responding to a spouse who just learned their partner sustained a severe traumatic brain injury. The spouse is pacing the hallway, crying uncontrollably, and states, "I do not know what to do. I cannot live without them." Arrange the following nursing interventions in the correct order of priority according to the principles of crisis intervention. (Place the first action at the top and the last action at the bottom.)

A nurse is developing a plan of care for a 62-year-old client who has just been admitted to the telemetry unit following a left-sided cardiac catheterization via the femoral approach. The client has a documented history of severe chronic obstructive pulmonary disease (COPD). Which of the following nursing actions are appropriate to reduce the risk of potential complications? (Select all that apply)

A nurse is caring for a client who has experienced profuse, watery diarrhea for the past 48 hours. The nurse monitors the client closely for early indications of hypovolemic shock. Which of the following vital sign changes represents the earliest physiological compensatory mechanism for fluid volume deficit?

An 82-year-old client with advanced Parkinson's disease is admitted for severe dehydration and profound weight loss. Assessment reveals pronounced bradykinesia, freezing of gait episodes, and prominent dysphagia with coughing during meals. When prioritizing the daily basic care, mobility, and comfort needs for this client, which of the following evidence-based interventions should be incorporated? Select all that apply.

An older adult client with generalized weakness and a history of mild dysphagia is about to receive their lunch tray. Which nursing action is most appropriate to promote safe swallowing and prevent aspiration?