A client is 24 hours postop from gastric bypass surgery. Which of the following nursing actions is best in preventing thrombus formation?
Anonymous Quiz
28%
The application of sequential compression devices
29%
Ambulating the client
34%
Administering salicylate (Aspirin)
9%
Massaging of lower extremities
❤2
What is the most appropriate action for a rapidly occurring wide QRS complex with no discernable p-waves?
Anonymous Quiz
28%
Shock the client with 200 J
42%
Perform chest compressions
21%
Administer oxygen
8%
Take a manual blood pressure
❤3
A school nurse should schedule which type of screening exam for all 12-year-olds enrolled in the school?
Anonymous Quiz
31%
Scoliosis
19%
Diabetes
21%
Hypertension
29%
Hearing
❤2
Which site is the best for administering total parenteral nutrition to a client whose feeding contains greater than 10% glucose?
Anonymous Quiz
11%
PEG tube
34%
NG tube
19%
Peripheral site
35%
Central catheter site
❤2
A client who takes digoxin (Lanoxin) at home has presented with a digoxin level of 4 ng/mL and a heart rate of 38. What is the priority nursing action?
Anonymous Quiz
8%
Set up the client for external pacing
29%
Administer Atropine 1 mg IV
39%
Administer Digibind 228 mg IV
24%
Assess the client for visual changes and nausea/ vomiting
❤2
A client is admitted with active tuberculosis. Which form of isolation should the client be placed on?
Anonymous Quiz
7%
Contact
47%
Droplet
38%
Airborne
8%
Standard
❤2
A client presents with a history of illegal use of prescription narcotics. Which assessment data is the earliest sign of withdrawal?
Anonymous Quiz
21%
BP 90/60, HR 100
47%
Anxiety, irritability
21%
Insomnia, diarrhea
12%
Nausea, vomiting
A client is being weaned from a patient controlled analgesic pump (PCA pump). Which nursing intervention would be best to assist in the control of pain?
Anonymous Quiz
19%
Provide small chatter in the background
31%
Play classical music in the background
23%
Darken the room and close the door
28%
Teach the client to only call for pain meds when pain is a 10/10
❤2
The nurse will plan to avoid performing which nursing actions on the left arm of a client with an arteriovenous fistula?
Anonymous Quiz
48%
Blood pressure monitoring
24%
Oxygen saturation monitoring
14%
Blood glucose monitoring
14%
Assessment of capillary refill
❤1
While developing the clinical pathway of four clients, which client will need a referral to speech therapy based on the nurse’s assessment?
Anonymous Quiz
11%
A client who experienced a fractured hip
66%
A client who underwent a laryngectomy
12%
A client who underwent a cholecystectomy
11%
A client who was admitted for congestive heart failure
❤4
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❤2
A 33-year-old client reports left leg pain, right-sided chest pain, and a sudden onset of shortness of breath. Which action should be taken immediately by the nurse?
Anonymous Quiz
5%
Take the client’s temperature
67%
Auscultate the client’s the lung sounds
14%
Percuss the client’s abdomen
14%
Request a stat chest x-ray
❤1
Which rationale should a nurse use to explain the reason for oxygen being bubbled through a humidifier to a client receiving 2 liters of oxygen by nasal cannula?
Anonymous Quiz
16%
Prevents the burning sensation of direction oxygen
58%
Prevents drying of the nasal passages
18%
Prevents a chemical reaction between the tubing and oxygen
8%
Prevents contamination with environmental gases
❤4
Which verbal complaint during the assessment of a 55-year-old female client is considered abnormal and requires further investigation?
Anonymous Quiz
17%
Absence of menstrual cycle
13%
Thinning of hair
31%
Periods of sweating and feeling warm
39%
Lumps in axilla area
❤2
Which intervention should the nurse implement when administering an intramuscular vitamin K injection to the newborn?
Anonymous Quiz
24%
Dilute the vitamin K with 1 mL normal saline
37%
Use a tuberculin syringe with a 5/8-inch needle
31%
Administer the injection in the dorsal gluteus
9%
Check the mother for any type of allergies
The client is receiving total parental nutrition (TPN) into a subclavian line at 73 mL/hr. Which intervention should the nurse implement?
Anonymous Quiz
18%
Infuse the solution via gravity at 73 mL/hr
43%
Monitor the serum blood glucose daily.
12%
Change the IV tubing every 3 days.
27%
Check intake and output (I&O) every shift.
The nurse assessing the client diagnosed with pancreatitis notes the client has a bluish discoloration around the umbilicus. Which intervention should the nurse implement next?
Anonymous Quiz
33%
Assess the left flank for bruising.
31%
Check the chart for the latest hemoglobin
10%
Note the finding in the chart.
25%
Notify the HCP
Which statement by the female client indicates that the client understands factors that may precipitate seizure activity?
Anonymous Quiz
31%
“I should not take birth control pills to prevent pregnancy.”
20%
“I need to limit my intake of dairy products.”
29%
“I should not participate in any contact sports.”
20%
“My menstrual cycle may affect my seizure disorder.”
A nurse is caring for a client diagnosed with cystic fibrosis who is refusing to take a recommended nebulizer treatment. The client’s refusal of treatment is classified as which of the following?
Anonymous Quiz
12%
A moral obligation
27%
A legal obligation
40%
An ethical right
21%
A basic human right
A nurse assesses heavy bleeding with large clots for a postpartum client 2 hours after delivery of a 10-pound infant. Which action should the nurse take initially?
Anonymous Quiz
30%
Perform fundal massage
28%
Notify the primary health-care provider
30%
Start a dilute oxytocin infusion intravenously
12%
Offer a bedpan or assist the woman in ambulating to the bathroom
❤2