Comprehensive Nursing Mastery: Critical Care, Cardiovascular, Renal, Electrolytes, Fluid & Volume Imbalances, Burns, ABG Interpretation, Acid-Base Disorders, Sepsis, Heart Failure, Myocardial Infarction, CABG, Stroke, Urinary Disorders, Delegation, Emerge

Comprehensive Nursing Mastery: Critical Care, Cardiovascular, Renal, Electrolytes, Fluid & Volume Imbalances, Burns, ABG Interpretation, Acid-Base Disorders, Sepsis, Heart Failure, Myocardial Infarction, CABG, Stroke, Urinary Disorders, Delegation, Emergency Interventions, Airway Management, Pharmacology, Lab Interpretation, Patient Safety, Nursing Assessment, Critical Interventions, Home Care, Education, High-Risk Populations Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 An elderly, confused client with dehydration is admitted to the medical unit. Which intervention would be appropriate for the RN to delegate to the unlicensed assistive personnel? 1. Perform a physical assessment. 2. Start an IV of NS with KCL 20 mEq at 50 mL/hr. 3. Insert a urinary Catheter. 4. Weigh the client 4. Correct: The UAP can weigh clients. How should the nurse interpret the arterial blood gas (ABG) results of a client admitted with dehydration? 1. Metabolic acidosis 2. Respiratory acidosis 3. Metabolic alkalosis 4. Respiratory alkalosis 5. Uncompensated 6. Partially compensated 7. Fully compensated 4 & 5 Correct: The blood gases confirm respiratory alkalosis. The HCO3 is normal. This means that the client is in uncompensated respiratory alkalosis. A client arrives in the emergency department in a postictal state after having a seizure for the first time. The nurse notes peripheral edema to the lower extremities. BP 100/68, Resp 18, HR 86. Family reports client has taken "a lot of antacids for indigestion over the past 48 hours. Current health history includes chronic renal failure. What acid/base imbalance does the nurse anticipate for this client? 1. Respiratory acidosis 2. Respiratory alkalosis 3. Metabolic acidosis 4. Metabolic alkalosis 4 Correct: This client condition indicate metabolic alkalosis. The home health nurse is visiting a client who had a stoke a several months ago. At today's visit, the client reports nausea, vomiting and anorexia for the last few days. During the assessment, the client becomes unresponsive, without a pulse. What action should the nurse take first? 1. Defibrillate at 200 joules 2. Administer amiodarone IV 150 mg over 10 minutes 3. Infuse 500 mL NS with 40 mEq at 100 mL/hour 4. Begin cardiopulmonary resuscitation 4 Correct: The nurse is in the client's home when the client becomes unresponsive without a pulse. The client has no IV and there is no defibrillator. So what should the nurse do? Start CPR and have someone activate EMS. The charge nurse is evaluating a new nurse who is performing a linear wound dressing change on a surgical client. Which action by the new nurse requires intervention by the charge nurse? 1. Hand hygiene is done prior to the dressing change. 2. Dressing tape is removed in the direction of the hair growth. 3. The soiled dressing is discarded in a biomedical waste bag. 4. Clean gloves are donned in order to clean the wound. 5. The wound area farthest from the nurse is cleaned first, then the center of the wound, followed by the area closest to the nurse. 6. New sterile dressing is applied to the wound. 4 & 5 Correct: Most dressing changes following surgery are sterile and require that the nurse use standard precautions and wear sterile gloves to clean the incision and apply sterile dressings. Clean gloves can be used to remove the old dressing. Dressings are never touched by ungloved hands. Remember, clean to dirty. The wound center is considered the cleanest area, so that is cleaned first. The area beside the wound farthest from the nurse is considered the next cleanest area. The area closes to the nurse is considered the most contaminated and is cleaned last. The new nurse performed this step correctly. A nurse is caring for a client who is on bed rest following admission to the hospital two days ago with a diagnosis of new onset heart failure. While evaluating the client's progress, what assessment findings would indicate to the nurse that treatment has been effective? 1. CVP 6 mmHg 2. 3.8 kg weight loss in 24 hours 3. Pink, frothy sputum 4. S3 heart sound 5. Urinary output 320 mL/8 hrs 6. Dyspnea on exertion 1, 2, & 5 Correct: These are all signs that the client is getting better. This is a normal CVP value, which would indicate the client is improving. A weight loss of 3.8 kg in 24 hours is a good thing. Excess fluid is being removed from the body. A urinary output of 320 mL in 8 hours is good. That averages out to 40 mL/hr. A client is admitted for treatment of fluid volume deficit. The nurse reviews the admitting lab work and the primary healthcare provider's prescriptions. Which prescription would be of concern to the nurse? 1. Diet 2. Furosemide 3. IV infusion 4. Potassium Chloride (KCL) 2 Correct: The client is in a fluid volume deficit. Furosemide is a loop diuretic which can be prescribed to get rid of excess fluid in the vascular space. Giving this medication will worsen the fluid volume deficit. What should the nurse assess when examining a client who has had a fasciotomy of the forearm? 1. Brachial pulse 2. Capillary refill 3. Color 4. Presence of thrill 5. Skin turgur