NSG 4800 EXAM QUESTIONS WITH ANSWERS
The nurse is monitoring a client in the immediate postpartum period
for signs of hemorrhage. Which sign, if noted, would be an early sign
of excessive blood loss?
A .temperature of 100.4°F (38°C)
B. An increase in the pulse rate from 88 to 102 beats/minute
C. A blood pressure change from 130/88 to 124/80 mm Hg
D. An increase in the respiratory rate from 18 to 22 breaths/minute -
CORRECT ANSWERS ✔✔B, During the fourth stage of labor, the
maternal blood pressure, pulse, and respiration should be checked
every 15 minutes during the first hour. An increasing pulse is an
early sign of excessive blood loss because the heart pumps faster to
compensate for reduced blood volume. A slight increase in
temperature is normal. The blood pressure decreases as the blood
volume diminishes, but a decreased blood pressure would not be the
earliest sign of hemorrhage. The respiratory rate is slightly increased
from normal.
The nurse in the ambulatory care unit is providing home care
instructions to a client after cryotherapy for the treatment of
malignant skin lesions. Which statement would be most appropriate
for the nurse to include in the home care instructions for this client?
"Apply ice to the site to prevent swelling."
,"Clean the site with alcohol 3 times daily."
"Apply a warm, damp washcloth if discomfort occurs."
"Avoid showering or taking baths until seen by the health care
provider in 1 week." - CORRECT ANSWERS ✔✔3, Cryotherapy
involves the local application of liquid nitrogen to the lesion; this
causes cell death and tissue destruction. Tissue freezing is followed
in 1 to 2 days by hemorrhagic blister formation; therefore, ice is not
applied to the site. The application of a warm, damp washcloth
intermittently to the site will provide relief of any discomfort. The
nurse instructs the client to clean the site with the prescribed
solution to prevent secondary infection. A topical antibiotic also may
be prescribed. Alcohol would cause irritation to the skin. There is no
reason for the client to avoid showering or bathing.
The registered nurse is caring for the following clients. It would be a
priority for the nurse to initiate a multidisciplinary conference for the
client who is
A.12 years old with Autism who is starting a new school and recently
had a URI (upper respiratory tract infection)
B.39 years old, has type 2 Diabetes Mellitus, is homeless and had a
recent Hemoglobin A1c of 13%
C.52 years old, with Myasthenia Gravis, recently prescribed Mestinon
(pyridostigmine) and is employed as a mail carrier
D.79 years old, has bipolar and schizophrenia, lives alone and reports
hearing non threatening voices. - CORRECT ANSWERS ✔✔B
, A client with uncontrolled Diabetes Mellitus would require the
greatest number of disciplines (multidisciplinary) to manage their
care i.e. Medicine, Nursing, Social Work, Nutritionist; the other
choices do not require as many providers of care to meet their needs.
A client is scheduled to begin therapy with carbamazepine. The
nurse should assess the results of which test(s) before administering
the first dose of this medication to the client?
Liver function tests
Renal function tests
Pancreatic enzyme studies
Complete blood cell count - CORRECT ANSWERS ✔✔D.
Carbamazepine may be used to treat a seizure disorder. It can cause
leukopenia, anemia, thrombocytopenia, and, very rarely, fatal
aplastic anemia. To reduce the risk of serious hematological effects, a
complete blood cell count should be done before treatment and
periodically thereafter. This medication should be avoided in clients
with preexisting hematological abnormalities. The client also is told
to report the occurrence of fever, sore throat, pallor, weakness,
infection, easy bruising, and petechiae. The results of the remaining
tests listed in the options are not associated with the use of this
medication.
A client is admitted to a hospital with a diagnosis of diabetic
ketoacidosis (DKA). The initial blood glucose level is 950 mg/dL
The nurse is monitoring a client in the immediate postpartum period
for signs of hemorrhage. Which sign, if noted, would be an early sign
of excessive blood loss?
A .temperature of 100.4°F (38°C)
B. An increase in the pulse rate from 88 to 102 beats/minute
C. A blood pressure change from 130/88 to 124/80 mm Hg
D. An increase in the respiratory rate from 18 to 22 breaths/minute -
CORRECT ANSWERS ✔✔B, During the fourth stage of labor, the
maternal blood pressure, pulse, and respiration should be checked
every 15 minutes during the first hour. An increasing pulse is an
early sign of excessive blood loss because the heart pumps faster to
compensate for reduced blood volume. A slight increase in
temperature is normal. The blood pressure decreases as the blood
volume diminishes, but a decreased blood pressure would not be the
earliest sign of hemorrhage. The respiratory rate is slightly increased
from normal.
The nurse in the ambulatory care unit is providing home care
instructions to a client after cryotherapy for the treatment of
malignant skin lesions. Which statement would be most appropriate
for the nurse to include in the home care instructions for this client?
"Apply ice to the site to prevent swelling."
,"Clean the site with alcohol 3 times daily."
"Apply a warm, damp washcloth if discomfort occurs."
"Avoid showering or taking baths until seen by the health care
provider in 1 week." - CORRECT ANSWERS ✔✔3, Cryotherapy
involves the local application of liquid nitrogen to the lesion; this
causes cell death and tissue destruction. Tissue freezing is followed
in 1 to 2 days by hemorrhagic blister formation; therefore, ice is not
applied to the site. The application of a warm, damp washcloth
intermittently to the site will provide relief of any discomfort. The
nurse instructs the client to clean the site with the prescribed
solution to prevent secondary infection. A topical antibiotic also may
be prescribed. Alcohol would cause irritation to the skin. There is no
reason for the client to avoid showering or bathing.
The registered nurse is caring for the following clients. It would be a
priority for the nurse to initiate a multidisciplinary conference for the
client who is
A.12 years old with Autism who is starting a new school and recently
had a URI (upper respiratory tract infection)
B.39 years old, has type 2 Diabetes Mellitus, is homeless and had a
recent Hemoglobin A1c of 13%
C.52 years old, with Myasthenia Gravis, recently prescribed Mestinon
(pyridostigmine) and is employed as a mail carrier
D.79 years old, has bipolar and schizophrenia, lives alone and reports
hearing non threatening voices. - CORRECT ANSWERS ✔✔B
, A client with uncontrolled Diabetes Mellitus would require the
greatest number of disciplines (multidisciplinary) to manage their
care i.e. Medicine, Nursing, Social Work, Nutritionist; the other
choices do not require as many providers of care to meet their needs.
A client is scheduled to begin therapy with carbamazepine. The
nurse should assess the results of which test(s) before administering
the first dose of this medication to the client?
Liver function tests
Renal function tests
Pancreatic enzyme studies
Complete blood cell count - CORRECT ANSWERS ✔✔D.
Carbamazepine may be used to treat a seizure disorder. It can cause
leukopenia, anemia, thrombocytopenia, and, very rarely, fatal
aplastic anemia. To reduce the risk of serious hematological effects, a
complete blood cell count should be done before treatment and
periodically thereafter. This medication should be avoided in clients
with preexisting hematological abnormalities. The client also is told
to report the occurrence of fever, sore throat, pallor, weakness,
infection, easy bruising, and petechiae. The results of the remaining
tests listed in the options are not associated with the use of this
medication.
A client is admitted to a hospital with a diagnosis of diabetic
ketoacidosis (DKA). The initial blood glucose level is 950 mg/dL
