(47) A client who weighs 132 pounds receives a prescription for lorazepam 44mcg/kg intravenously to be administer

(47) A client who weighs 132 pounds receives a prescription for lorazepam 44mcg/kg intravenously to be administer 20 minutes before a procedure. The medication is available in 2mg/mL vial. How many ML should the nurse administer? (Enter numerical value only)

(51) A client who is obese reports severe pain and is unable to bear weight in the right ankle after making dietary changes 3 weeks ago. The client medical history includes hypertension, gouty arthritis, and cholecystitis. Which instruction should the nurse include in the discharge teaching

(a) Use electric heating pad when pain is at its worse

(b) Substitute natural fruit juices for carbonated drinks

(c) Avoid the consumption of wine, beer, and coffee

(d) Encourage active range of motion to limit stiffness

(53) A week after admission to intensive care for a bowel obstruction, a client is confused to time and place. The nurse frequently attempts to reorient but the client remains confused. Which intervention should the nurse implement for the client’s safety?

(a) Administer a mild sedative as needed

(b) Apply an approved vest restraint

(c) Increase direct observation times

(d) Suggest rotating visits to the family

(54) The nurse is assessing a client who is receiving enteral feedings. Which clinical data indicate the client may not be tolerating the feeding ( select all that apply)

(a) Absent bowel sounds

(b) Abdominal cramping

(c) Flatulence

(d) Nausea and Vomiting

(e) Abdominal tympany

(55) A client with ureterolithiasis is preparing for discharge after a ureteroscopy removal. Which instruction should the nurse include in the post operative discharge teaching?

(a) Monitor urinary stream for decreased output

(b) Restrict physical activities

(c) Report when hematuria becomes pink tinged

(d) Use incentive spirometer

(56) A male client who was in a motor vehicle collision yesterday is receiving a unit of packed red blood cells. When half of the unit is administered, the client complains of lower back pain, and the nurse observes a fine rash over his chest and back. Which intervention should the nurse implement?

(a) Instruct the client to avoid lying on his back

(b) Replace the transfusion with normal saline

(c) Administer scheduled dose of glucocorticoid

(d) Apply an anti-inch ointment over the rash area

(57) The nurse is caring for a client with a binge eating disorder. Which goal should the nurse first establish with the client?

(a) Regulate food portions

(b) Achieve a steady weight loss

(c) Institute an exercise plan

(d) Obtain satisfaction with appearance

(59) A nurse brings an oral medication prescribed to be given daily to a male client who tells the nurse that he will take his medications later. What should the nurse implement?

(a) Inform the client that his medication is scheduled to be taken now

(b) Leave the medication on the bedside table with a fresh glass of water

(c) Agree upon a time to return to the client’s room with the medication

(d) Note the client’s noncompliance with medications in the nurses’ notes

(60) The nurse is planning discharge instructions for a client with type 2 diabetes who will be starting exenatide. Which information should the nurse include in the discharge instructions

(a) Exenatide acts in the same way as insulin in lowering blood glucose

(b) Notify your healthcare provider if you start having abdominal pain

(c) There are no precautions about taking exenatide with other medications

(d) Inject exenatide within 30 minutes before or after a meal

(61) The nurse is preparing to administer 1.6 ML of medication intravenously to a 4-month-old infant. Which action should the nurse implement?

(a) Administer into the deltoid muscle while the parent holds the infant securely

(b) Select a 22 gauge 1 ½ inch (3.8 cm) needle for the intramuscular injection

(c) Divide the medication into two injections with volumes under 1 ML

(d) Use a quick dart like motion to inject into the dorsolateral site

(62) A client who is aspired at the time of endotracheal intubation has developed acute respiratory distress syndrome, the nurse observe for clients Spo2 is 85% on 80% FiO2 with positive end expiratory pressure (PEEP) set at 5cm H2O, coughing against the ventilator. Which intervention should the nurse implement?

(a) Perform endotracheal suctioning

(b) Hyperventilate with 100% via ventilator

(c) Medicate with IV pain medication

(d) Ask respiratory therapist to decrease PEEP

(63) Four days after exposure to corona virus (COVID-19) a client has a negative COVID-19 test result. Eight days after the negative result, the client present with fever, fatigue, and cough and the nurse performs a second COVID-19 test. Which action is most important for the nurse to implement?

(a) Update the client and family regarding the COVID 19 vaccines that are available

(b) Move the client to a private room, Keep the door closed, and initiate droplet precautions

(c) Notify the charge nurse the client will need assignment to the COVID-19 specified area of the facility

(d) Teach the client to wear a mask, hand wash and social distance to prevent spreading of the virus

(65) The nurse is caring for a client with the sexually transmitted infection (STI) syphilis. The client reports unprotected sex. Which information would the nurse provide?

(a) Provide counseling that most contraceptive protect against infection

(b) Clarify that all STIs are transmitted through sexual intercourse

(c) Explain the reinfections occurs from sex with untreated partners

(d) Emphasize that using safe sex practices removes the risk of STIs

(66) Which assessment should the home health nurse include during a routine home visit for a client who was discharged home with a suprapubic catheter

(a) Assess the perineal area

(b) Palpate flank area

(c) Measure abdominal girth

(d) Observe insertion site

(70) A nurse caring for a toddler with Kawasaki disease who is receiving intravenous immunoglobin for severe coronary inflammation teaching for the parents. Which instruction should the nurse provide during the discharge education?

(a) Plan for a follow up echocardiogram occurring in 4 to 6 weeks

(b) Manage joint pain with a non-steroidal anti-inflammatory

(c) Resume the toddler’s normal immunization schedule

(d) Irritability and tinnitus are expected for up to 2 weeks

(72) The nurse is providing education to a client who receives a prescription for zolpidem. Which information about the medication should the nurse include?

(a) Store at room temperature

(b) Crush to increase absorption

(c) Take before bedtime

(d) Administer with a meal

(73) The nurse is collecting a heel stick blood specimen for a neonatal screen, which includes thyroxine (T4) and thyroid stimulating hormone (TSH) for discharge of a 2-day old newborn. When the parent asks why these tests are being conducted, which explanation should the nurse provide? ****

(a) Dosage for thyroid replacement therapy will be determined by this test

(b) This technique is used for early detection of mental retardation

(c) This is a routine blood test required by law to screen for metabolic deficiencies

(d) These lab values will provide data to anticipate delays in growth and development

(75) While caring for a clients post operative dressing, the nurse observes a red and swollen wound with a moderate and a foul odor. Before reporting this finding to the healthcare provider, the nurse should note which of the client’s laboratory levels?

(a) Neutrophil count

(b) Serum albumin

(c) Creatinine level

(d) Serum potassium and sodium levels

(77) An older client with dementia who is refusing to allow an unlicensed assistive personnel (UAP) bathe her, is becoming increasingly aggressive and said the UAP wants to hurt her and tie her up. Which approach should the nurse use with the client?

(a) Clarify reality with the client about delusional thoughts

(b) Awaken the client earlier for daily morning care

(c) Reduce the client’s interaction with others during the day

(d) Use distraction and therapeutic communication skills

(79) The nurse is caring for a client who reports sudden right sided numbness and weakness of the arm and leg. The nurse also observes a right sided facial drop. After reporting the finding to the healthcare provider, the nurse receives several prescriptions for the client, including computerized tomography scan of the head. Which intervention should the nurse perform in the immediate management of the *****

(a) Initiate bilateral intermittent sequential pneumatic compression devices

(b) Maintain elevated positioning of the dependent joints on affected side

(c) Obtain a focused history to determine recent bleeding and use of anticoagulants

(d) Raise the head of the bed to 30 degrees keeping head and neck in neutral alignment

(80) The nurse is providing supplemental oxygen to a client who is experiencing a cluster headache. In evaluating the effectiveness. What is most important for the nurse to make?

(a) Measure pain

(b) Observe skin color

(c) Assess oxygen saturation

(d) Auscultate breath sounds

(85) The nurse prepares to teach four clients about diabetes mellitus. Which client has the greatest need for instructions?

(a) A female who has gestational diabetes and has a 2-hour postprandial glucose at 140 mg/dL (7.8 mmol/L)

(b) An adolescent male who has type1 diabetes and a random glucose at 120 mg/dL (6.7 mmol/L)

(c) An adult who has type 2 diabetes and has a glycosylated hemoglobin (Hb A1C) at 10%

(d) A child with asthma, who takes prednisone and has a fasting serum glucose at 180 mg/dL (10mmol/L)

(86) The nurse assigns unlicensed assistive personnel (UAP) to a client who has been placed on droplet precautions for a respiratory disease. The UAP request a change of assignment, stating she has not yet been fitted for particulate filter mask. which action should the nurse take?

(a) Before changing assignment, determine which staff members have fitted particulate filter masks

(b) Instruct the UAP that a standard face mask is sufficient to be able to provide care for the assigned client

(c) Advise the UAP to wear a standard facemask to obtain vital signs, and then get fitted for a filter mask before procedure

(d) Send the UAP to be fitted for a particulate filter mask immediately so she can provide care to this client

(87) A client with type 2 diabetes mellitus and hyperlipidemia is admitted to the medical unit with pneumonia. The client is assessing a serum blood glucose of 385 mg/dL (21.37 mm/L). Which finding should the nurse recognize as a possible complication?

(a) No appetite with nausea

(b) Dark yellow urine

(c) Myalgia in wrists and hands

(d) Cervical spine stiffness

(88) A male client with suspected lung cancer tells the nurse that he does not want to have a scheduled biopsy performed, and states, “They the cancer when I had my chest x-ray,” Which action should the nurse implement?

(a) Reassure the client that he will be sedated during the endoscopic procedure

(b) Explain that a biopsy is performed to determine if the cancer has spread

(c) Encourage the client to verbalize his feeling about his diagnosis of lung cancer

(d) Instruct the client that biopsy results are important to determine the best treatment

(89) The nurse is caring for an older client with an intestinal obstruction and a history of multiple abdominal surgeries. The client is experiencing colicky abdominal pain, nausea, vomiting , and abdominal distention. Which pathophysiologic mechanism supports the clients clinical

(a) Scar tissue from a chronic intestinal condition

(b) Bowel strangulation

(c) Congenital abnormality of the bowel

(d) Metastatic abdominal carcinoma

(90) In preparing nursing care for a client after gastric endoscopy, which commonly occurring procedure should the nurse include intervention for is the possibility of care ******

(a) Headache

(b) Sore throat

(c) Nausea

(d) Aching leg

(92) The nurse is caring for a client who receives a prescription for valproic acid in which the maximum safe dosage is 60mg/kg/day. How much maximum safe dosage for a client who weighs 176 pounds? (Enter numerical value only)

(93) The nurse is developing a plan of care for an older male client with type 2 diabetes who reports blurred vision. Which outcome should be in the pan of care for this client?

(a) The client will express acceptance of his changing health status

(b) The client’s family will state signs and symptoms about the disease

(c) The nurse will dominate the procedure for accurate eye care

(d) The clients daily blood pressure will be less than 140/80 mmHg this month.

(94) A client receiving thyroid replacement therapy following a thyroidectomy is seen in the clinic 6 weeks following the surgery. Which assessment is important for the nurse to obtain?

(a) Pulse rate and body weight

(b) Daily caloric intake

(c) Report of bowel functioning since surgery

(d) Number of any missed doses of medication

(96) A client in labor begins bleeding profusely from the vagina. Which findings should the nurse report to the healthcare provider?

(a) Increase in pulse and fetal rate reactivity

(b) Pain in lower quadrant and oliguria

(c) Mild discomfort and elevated blood pressure

(d) Sharp fundal pain and uterine tenderness

(98) A client telemetry monitor indicates ventricular fibrillation (VF). Which action should the nurse implement immediately?

(a) Give a dose of amiodarone IV

(b) Defibrillate with one shock

(c) Administer IV atropine

(d) Prepare for external pacing

(100) A client arrives at a hurricane disaster medical area seeking treatment for diarrhea. What is the most likely source of contamination that the nurse state when interviewing the client about exposure?

(a) Food contamination from flood waters

(b) Nosocomial transmission in the medical area

(c) Drinking water contaminated by sewage

(d) Close living quarters at evacuation centers

(101) The nurse should expect a client diagnosed with regional enteritis (Crohn’s disease) to exhibit what initial symptoms?

(a) Diarrheas, abdominal pain and weight loss

(b) Dull, left lower cramping pain and low-grade fever

(c) Rigid board-like abdomen and elevated white blood cell count

(d) Change in bowel habits, blood in stool, and unexplained anemia

(104) While providing a health history, a female client tells the clinic nurse that she frequently thinks about hurting herself. Which questions is the

(a) “Are you having problems concentrating”

(b)” Do you often have feelings of sadness”

(c) “What problems are you facing right now”

(d) “Have you thought about taking your life”

(106) A middle-aged client diagnosed with graves disease, asks the nurse about this condition. Which etiological symptoms about hypothyroidism? (Select all that apply) ***

(a) Weight gain is a common complaint in hyperthyroidism

(b) Early treatment includes levothyroxine

(c) Graves disease, an autoimmune condition, affects thyroid stimulating hormone receptors

(d) T3 and T4 hormone levels are increased

(e) Large protruding eyeballs are a sign of hyperthyroid function.

(107) A client is admitted to the labor and delivery unit in early labor and the nurse assesses the status of her contractions. The frequency of contractions should be evaluated by counting the minutes and seconds in which manner?

(a) From the beginning of one contraction to the end of the next contraction

(b) From the peak of one contraction to the peak of the next contraction

(c) From the end of one contraction to the beginning of the next contraction

(d) From the beginning of one contraction to the end of that contraction

(109) A client with type 1 diabetes mellitus reports blood glucose levels between 180 and 210mg/dL (10 to 11.7 mmol/L) upon wakening each time also reports experiencing an increase in disturbing dreams and diaphoresis during the night. Which instruction should the nurse include for the client *****

(a) Have the glucose monitor recalibrated

(b) Report to the clinic for a fasting serum glucose

(c) Check blood glucose during the night

(d) Eat a high carbohydrate snack before bed

(112) The nurse receives report on four clients who are complaining of increased pain. Which client requires immediate intervention by the nurse ****

(a) Burning pain due to a Morton’s neuroma

(b) Sharp pain related to a crushed femur

(c) Stinging pain related to plantar fasciitis

(d) Paresthesia of fingers due to carpal tunnel syndrome

(114) The nurse is caring for a client with irritable bowel syndrome who presents with diarrhea and cramping abdominal pain. Which pathophysiology mechanism supports this client’s clinical presentation?

(a) A history of having Helicobacter pylori infection

(b) Nerve degeneration due to chronic gastric reflux

(c) Tissue swelling due to an autoimmune response

(d) A weakened diaphragm with high abdominal pressure

(121) A client who has emphysema and recently experienced a stroke receives a prescription for a metered dose inhaler with a

(a) It allows the medication to slowly enter the lungs

(b) It prevents mouth infections when an inhaler is used

(c) It allows times to inhale the center dispensed dose

(d) It increases the effectiveness of the medication

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