NUR 426 Exam 1 Practice Questions With Complete
Solutions
A 20 year old female with sickle cell says that she does not
know how she ended up in a vaso-occlusive crisis as she has
been "really good" about keeping hydrated, monitoring her
activity, and avoiding people who are sick. Her parents moved
out of state and she reports it "feels different being on my own."
The nurse, knowing the pathophysiology of sickle cell anemia
and the triggers for crisis, should respond with which statement?
A. "You must be experiencing a different type of sickle cell
crisis because you have been doing everything right."
B. "As a college student you are likely drinking too much
alcohol. It's important that you avoid it."
C. "These crises just happen from time to time and there is not
much that can be done to prevent it."
D. "Stress can also be a trigger for a crisis. It can be a
psychological stressor or a physical stressor." Correct Answers
D. "Stress can also be a trigger for a crisis. It can be a
psychological stressor or a physical stressor."
A 23-year old male in the Emergency Department who is
experiencing acute onset of shortness of breath.
For each intervention, select if the intervention should be
performed immediately, within the hour, or by discharge (from
the ED).
A. Instruct the client on peak flowmeter
B. Administer 2L of oxygen via nasal cannula
C. Administer IV methylprednisolone ordered stat
,D. Administer ordered ipratropium nebulizer treatment ordered
q 2 hours
E. Instruct client on pursed lip breathing exercises
F. Instruct client on home meds
G. Apply continuous pulse oximetry Correct Answers A. by
discharge
B. immediately
C. immediately
D. within the hour
E. within the hour
F. by discharge
G. immediately
A child with hemophilia wants to play a sport, which one should
the nurse recommend?
A. none, phyiscal activity needs to be limited
B. basketball
C. soccer
D. swimming Correct Answers D. swimming
A client currently reports having more difficulty taking in a "full
breath," has a history of COPD, and denies pain. Select whether
the medications are appropriate for the nurse to administer now
or not appropriate for the nurse to administer now.
A. Ipratropium bromide and albuterol 0.5 mg/2.5 mg nebulizer
treatment 4 times a day.
B. Acetaminophen 650 mg po every 6 hours as needed for pain
C. Methylprednisolone 40 mg IV push x 1 dose
D. Cefuroxime 500 mg po bid
,E. Influenza vaccine IM x 1 Correct Answers A. appropriate
B. not appropriate
C. appropriate
D. not appropriate
E. not appropriate
A client in a sickle cell crisis is receiving a blood transfusion.
They are crying and asking for something for their pain. The
pain is in their back and lower legs. The nurse notes that there is
about 30 minutes left in the client's transfusion.
The client has a PCA pump of morphine and a prescription for
PRN morphine IV for breakthrough pain. Select whether the
nursing actions that are appropriate or not appropriate at this
time.
A. Stop the blood transfusion.
B. Push the button for the client on the PCA pump.
C. Administer a dose of morphine for breakthrough pain through
the PCA IV line.
D. Pause the blood transfusion and administer the morphine for
breakthrough pain through the blood IV line.
E. Apply warm compresses to the client's back and legs.
F. Encourage the client to drink a glass of water.
G. Notify the provider about the transfusion reaction. Correct
Answers A. not appropriate
B. not appropriate
C. appropriate
D. not appropriate
E. appropriate
F. appropriate
G. not appropriate
, A client is being admitted for a heparin infusion. CXR
completed and showed presence of pulmonary emboli. The
nurse notes that a urinalysis was completed on Ms. Grayson.
What is the primary reason for the urinalysis?
A. Ascertains if the client is dehydrated and needs intravenous
fluid.
B. Determines if confusion and temperature were from an
infection.
C. Provides data that may contraindicate the use of heparin.
D. Serves as a baseline for comparison if a heparin complication
occurs. Correct Answers D. Serves as a baseline for comparison
if a heparin complication occurs.
A client is receiving discharge instructions for an inhaled
corticosteroid metered
dose inhaler. Which teaching should the nurse include?
A. Discard the use of fluticasone if albuterol provides relief
B. Do not swallow the water as you wash your mouth after each
use
C. If taking albuterol, be sure to use after the steroid
D. Steroid inhalers should be used before beta 2 agonists.
Correct Answers B. Do not swallow the water as you wash your
mouth after each use
A nurse recognizes which clinical manifestations and lab values
as being the most significant indicators of DIC in a client?
(Select all that apply)
Solutions
A 20 year old female with sickle cell says that she does not
know how she ended up in a vaso-occlusive crisis as she has
been "really good" about keeping hydrated, monitoring her
activity, and avoiding people who are sick. Her parents moved
out of state and she reports it "feels different being on my own."
The nurse, knowing the pathophysiology of sickle cell anemia
and the triggers for crisis, should respond with which statement?
A. "You must be experiencing a different type of sickle cell
crisis because you have been doing everything right."
B. "As a college student you are likely drinking too much
alcohol. It's important that you avoid it."
C. "These crises just happen from time to time and there is not
much that can be done to prevent it."
D. "Stress can also be a trigger for a crisis. It can be a
psychological stressor or a physical stressor." Correct Answers
D. "Stress can also be a trigger for a crisis. It can be a
psychological stressor or a physical stressor."
A 23-year old male in the Emergency Department who is
experiencing acute onset of shortness of breath.
For each intervention, select if the intervention should be
performed immediately, within the hour, or by discharge (from
the ED).
A. Instruct the client on peak flowmeter
B. Administer 2L of oxygen via nasal cannula
C. Administer IV methylprednisolone ordered stat
,D. Administer ordered ipratropium nebulizer treatment ordered
q 2 hours
E. Instruct client on pursed lip breathing exercises
F. Instruct client on home meds
G. Apply continuous pulse oximetry Correct Answers A. by
discharge
B. immediately
C. immediately
D. within the hour
E. within the hour
F. by discharge
G. immediately
A child with hemophilia wants to play a sport, which one should
the nurse recommend?
A. none, phyiscal activity needs to be limited
B. basketball
C. soccer
D. swimming Correct Answers D. swimming
A client currently reports having more difficulty taking in a "full
breath," has a history of COPD, and denies pain. Select whether
the medications are appropriate for the nurse to administer now
or not appropriate for the nurse to administer now.
A. Ipratropium bromide and albuterol 0.5 mg/2.5 mg nebulizer
treatment 4 times a day.
B. Acetaminophen 650 mg po every 6 hours as needed for pain
C. Methylprednisolone 40 mg IV push x 1 dose
D. Cefuroxime 500 mg po bid
,E. Influenza vaccine IM x 1 Correct Answers A. appropriate
B. not appropriate
C. appropriate
D. not appropriate
E. not appropriate
A client in a sickle cell crisis is receiving a blood transfusion.
They are crying and asking for something for their pain. The
pain is in their back and lower legs. The nurse notes that there is
about 30 minutes left in the client's transfusion.
The client has a PCA pump of morphine and a prescription for
PRN morphine IV for breakthrough pain. Select whether the
nursing actions that are appropriate or not appropriate at this
time.
A. Stop the blood transfusion.
B. Push the button for the client on the PCA pump.
C. Administer a dose of morphine for breakthrough pain through
the PCA IV line.
D. Pause the blood transfusion and administer the morphine for
breakthrough pain through the blood IV line.
E. Apply warm compresses to the client's back and legs.
F. Encourage the client to drink a glass of water.
G. Notify the provider about the transfusion reaction. Correct
Answers A. not appropriate
B. not appropriate
C. appropriate
D. not appropriate
E. appropriate
F. appropriate
G. not appropriate
, A client is being admitted for a heparin infusion. CXR
completed and showed presence of pulmonary emboli. The
nurse notes that a urinalysis was completed on Ms. Grayson.
What is the primary reason for the urinalysis?
A. Ascertains if the client is dehydrated and needs intravenous
fluid.
B. Determines if confusion and temperature were from an
infection.
C. Provides data that may contraindicate the use of heparin.
D. Serves as a baseline for comparison if a heparin complication
occurs. Correct Answers D. Serves as a baseline for comparison
if a heparin complication occurs.
A client is receiving discharge instructions for an inhaled
corticosteroid metered
dose inhaler. Which teaching should the nurse include?
A. Discard the use of fluticasone if albuterol provides relief
B. Do not swallow the water as you wash your mouth after each
use
C. If taking albuterol, be sure to use after the steroid
D. Steroid inhalers should be used before beta 2 agonists.
Correct Answers B. Do not swallow the water as you wash your
mouth after each use
A nurse recognizes which clinical manifestations and lab values
as being the most significant indicators of DIC in a client?
(Select all that apply)
