Questions and CORRECT Answers
Which medication order for a client with a pulmonary 1 because 1.0 can be interpreted as 10 = overdose of med
embolism is most important to clarify with the prescribing
physician before administration?
1. Warfarin (coumadin) 1.0 mg PO
2. Morphine sulfate 2-4 mg IV
3. Cephalaxin (Keflex) 250 mg PO
4. Heparin infusion at 900 units/hr
The UAP tells you that a patient who is receiving oxygen 1 because when flow rate is higher than 4 L/min, mucous membranes can be dried
at a flow rate of 6 L/min by nasal cannula is reporting out
nasal passage discomfort. What intervention should you
suggest to improve the patient's comfort for this
problem?
1. Humidify patient's oxygen.
2. Use simple face mask instead of a nasal cannula
3. Provide pt with an extra pillow
4. Have pt sit up in a chair at the bedside
You are supervising an RN who floated from the med- 2, 3, 4, 5 because correct position is upright and leaning forward to prevent blood
surg unit to the emergency department. The nurse is from entering stomach and avoid aspiration; all other actions are appropriate
providing care for a patient admitted with anterior
epistaxis (nosebleed). Which directions would you clearly
provide to the RN? (Select all that apply)
1. Position pt in supine and turned on his side
2. Apply direct lateral pressure to the nose for 5 minutes
3. Maintain standard body substance precautions
4. Apply ice or cool compresses to the nose
5. Instruct pt not to blow the nose for several hours
You are admitting a pt for whom a diagnosis pulmonary 1. because pt who have recently experienced trauma are at risk for DVT and PE
embolus must be ruled out. The pt's history and
assessment reveal all of these findings. Which finding
supports the diagnosis of pulmonary embolus?
1. The pt was recently in a motor vehicle crash
2. The pt participated in an aerobic exercise program for
6 months
3. The pt gave birth to her youngest child 1 year ago
4. The pt was on bedrest for 6 hours after a diagnostic
procedure
, Which intervention for a pt with a pulmonary embolus 4. because an LPN/LVN who has been trained to auscultate lung sounds can
could be delegated to the LPN/LVN on your pt care gather data by routine assessment and observation, under supervision of RN
team?
1. Evaluating the pt's report of chest pain
2. Monitoring laboratory values for changes in
oxygenation
3. Assessing for symptoms of respiratory failure
4. Auscultating the lungs for crackles
A pt with a pulmonary embolus is receiving 1, 2, 3, 5 because it is important to avoid trauma to rectal tissue while on coagulant
anticoagulation therapy with IV heparin. What instructions therapy because it could cause bleeding
would you give the UAP who will help the pt with ADL's?
1. Use a lift sheet when moving and positioning the pt in
bed
2. Use an electric razor when shaving the pt each day
3. Use a soft-bristled toothbrush or tooth sponge for oral
care
4. Use a rectal thermometer to obtain a more accurate
body temp
5. Be sure pt's footwear has a firm sole when the pt
ambulates
A client is admitted to the hospital with a diagnosis of 5, 2, 3, 4, 1
pneumonia. List the following nursing actions in the order
they should be accomplished.
1. Check peak and trough levels of the antibiotic
2. Insert IV catheter to establish venous access.
3. Collect a sputum sample for culture and sensitivity
4. Administer prescribed antibiotic IV piggyback.
5. Obtain data about the client's history and physical
status.
Levofloxacin (Levaquin) 750 mg IVPB is prescribed for a 150mL/90min x 15dropspermL = 25 gtt/min
client with pneumonia. The dose available is 150 mL of 5%
dextrose and is to infuse over 90 minutes. The
administration set has a drop factor of 15 drops per mL. At
how many drops per min should the nurse regulate the
IVPB to infuse? Round to nearest whole number.
A nurse uses abdominal-thoracic thrusts (Heimlich 2. residual volume is the amount of air remaining in the lungs after maximum
maneuver) when an older adult in a senior center chokes exhalation
on a piece of meat. Which volume of air is the basis for
the efficacy of the abdominal thrusts to expel a foreign
object in the larynx?
1. Tidal
2. Residual
3. Vital Capacity
4. Inspiratory reserve