A client is in shock and the nurse prepares to administer insulin for a blood glucose
reading of 208 mg/dL. The spouse asks why the client needs insulin as the client is not
a diabetic. What response by the nurse is best?
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High glucose. is common in shock and needs to be treated.
A client is 4 hours postoperative after a femoropopliteal bypass. The client reports
throbbing leg pain on the affected side, rated as 7/10. What action by the nurse takes
priority?
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Assess distal pulses and skin color.
,An emergency room nurse assesses a client who was rescued from a home fire. The
client suddenly develops a loud, brassy cough. Which action should the nurse take
first?
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Apply oxygen and continuous pulse oximetry.
What conditions might the S1 sound be intensified?
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-Exercise.
-Hyperthyroidism.
-Mitral stenosis.
A nurse cares for a client with right-sided heart failure. The client asks, Why do I need
to weigh myself every day? How should the nurse respond?
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Weight is the best indication that you are gaining or losing fluid.
A nurse uses the rule of nines to assess a client with burn injuries to the entire back
region and left arm. How should the nurse document the percentage of the clients
body that sustained burns?
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, 27%.
A nursing student planning to teach clients about risk factors for coronary artery
disease (CAD) would include which topics?
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-Advanced age.
-Diabetes.
-Ethnic background.
-Smoking.
A client is being discharged home after a large myocardial infarction and subsequent
coronary artery bypass grafting surgery. The clients sternal wound has not yet healed.
What statement by the client most indicates a higher risk of developing sepsis after
discharge?
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I hope I can get my water turned back on when I get home.
A student nurse needs to listen to the apical pulse for a full 60 seconds. The RN
knows the nurse is listening in the correct place if the stethoscope is placed where?
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Mitral valve.
, A nurse plans care for a client with burn injuries. Which interventions should the nurse
include in this clients plan of care to ensure adequatenutrition?
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-Provide at least 5000 kcal/day.
-Administer a diet high in protein.
-Collaborate with a registered dietitian.
-Offer frequent high-calorie snacks.
A nurse teaches a client who is prescribed digoxin (Lanoxin) therapy. Which statement
should the nurse include in this clients teaching?
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Do not take this medication within 1 hour of taking an antacid.
A nurse caring for a client notes the following assessments: white blood cell count
3800/ mm3, blood glucose level 198 mg/dL, and temperature 96.2 F (35.6 C). What
action by the nurse takes priority?q
Give this one a try later!
Notify the HCP immediately.
reading of 208 mg/dL. The spouse asks why the client needs insulin as the client is not
a diabetic. What response by the nurse is best?
Give this one a try later!
High glucose. is common in shock and needs to be treated.
A client is 4 hours postoperative after a femoropopliteal bypass. The client reports
throbbing leg pain on the affected side, rated as 7/10. What action by the nurse takes
priority?
Give this one a try later!
Assess distal pulses and skin color.
,An emergency room nurse assesses a client who was rescued from a home fire. The
client suddenly develops a loud, brassy cough. Which action should the nurse take
first?
Give this one a try later!
Apply oxygen and continuous pulse oximetry.
What conditions might the S1 sound be intensified?
Give this one a try later!
-Exercise.
-Hyperthyroidism.
-Mitral stenosis.
A nurse cares for a client with right-sided heart failure. The client asks, Why do I need
to weigh myself every day? How should the nurse respond?
Give this one a try later!
Weight is the best indication that you are gaining or losing fluid.
A nurse uses the rule of nines to assess a client with burn injuries to the entire back
region and left arm. How should the nurse document the percentage of the clients
body that sustained burns?
Give this one a try later!
, 27%.
A nursing student planning to teach clients about risk factors for coronary artery
disease (CAD) would include which topics?
Give this one a try later!
-Advanced age.
-Diabetes.
-Ethnic background.
-Smoking.
A client is being discharged home after a large myocardial infarction and subsequent
coronary artery bypass grafting surgery. The clients sternal wound has not yet healed.
What statement by the client most indicates a higher risk of developing sepsis after
discharge?
Give this one a try later!
I hope I can get my water turned back on when I get home.
A student nurse needs to listen to the apical pulse for a full 60 seconds. The RN
knows the nurse is listening in the correct place if the stethoscope is placed where?
Give this one a try later!
Mitral valve.
, A nurse plans care for a client with burn injuries. Which interventions should the nurse
include in this clients plan of care to ensure adequatenutrition?
Give this one a try later!
-Provide at least 5000 kcal/day.
-Administer a diet high in protein.
-Collaborate with a registered dietitian.
-Offer frequent high-calorie snacks.
A nurse teaches a client who is prescribed digoxin (Lanoxin) therapy. Which statement
should the nurse include in this clients teaching?
Give this one a try later!
Do not take this medication within 1 hour of taking an antacid.
A nurse caring for a client notes the following assessments: white blood cell count
3800/ mm3, blood glucose level 198 mg/dL, and temperature 96.2 F (35.6 C). What
action by the nurse takes priority?q
Give this one a try later!
Notify the HCP immediately.
