NURS 4010 CAT VERSION 1

NURS 4010 CAT VERSION 1 At a routine prenatal visit, a client at 24-weeks gestation complains of nasal stuffiness and occasional nosebleeds. Which hormone is responsible for these changes? A. Human chorionic gonadotropin. B. Progesterone. C. Relaxin. D. Estrogen. 2. A client who has localized eczematous eruptions on b oth hands is diagnosed as having contact dermatitis. What instruction should the nurse include in this client's discharge teaching plan? A. Wear latex gloves whenever outdoors. B. Apply an oil-based ointment to the affected areas. C. Take prescribed antihistamine near bedtime. D. Soak hands in warm soapy water three times a day. 3. While transcribing a new prescription, the nurse notes that the prescribed dosage is much lower than the recommended dosage listed in the drug reference guide. Which client data supports the dosage reduction? A. Decreased serum creatinine B. Increased serum protein. C. Increased liver enzymes. D. Prolonged prothrombin time. 
 4. The nurse assigns an unlicensed assistive personnel (UAP) to take the vital signs of a client who is positive for Human Immunodeficiency Virus (HIV). What protective apparel should the nurse counsel the UAP to wear when carrying out this assignment? A. None. B. Gown, gloves, mask. C. Gloves and mask. D. Gloves only. 5. A client with Guillain-Barre syndrome requires a tracheostomy and mechanical ventilation due to the progression of the disease. What nursing intervention is most helpful in aiding this clinet to communicate with the staff and family? A. Speak slowly and disntinctly while in direct view of the client. B. Teach the client to point to a letter board word chart to communicate needs. C. Provide the client with a pencil and tablet of paper. D. With the client, develop a system of eye blinks to communicate "yes" or "no." 6. A client with peptic ulcer disease (PUD) is admitted to the emergency room complaining of sudden severe upper abdominal pain. Assessment indicates an extremely tender and rigid abdomen, B/P of 90/60 mmHg, and pulse of 110 beat/minute. The emergency department nurse should anticipate implementation of which intervention? A. Preparing the client for emergency abdominal surgery. B. Infusing the proton pump inhibitor Protonix intravenously. C. Administering an iced saline lavage. D. Inserting a nasogastric tube to decompress the bowel. 7. Which finding should the nurse expect a client to exhibit who is newly diagnosed with fibromyalgia? A. Recent joint trauma. B. Disruption in sleep patterns. C. Unexplained weight gain. D. Itching and rash. 8.A male client with diabetes mellitus reports that he has had trouble following his diet, and the result of his fasting blood glucose test is 90 mg/dl. What action should the nurse implement first? A. Obtain a urine specimen from the client to test for ketonuria. B. Assure the client that his diabetes control is within normal limits. C. Schedule the client to attend classes about diet management. D. Review the findings of his glycosylated hemoglobin test. 9. A multipara postpartum client complain intense cramping while breastfeeding. Whar instruction should the nurse provide to the client? A. Change the infant's position during the next feeding. B. Void and completely empty bladder before each feeding. C. Take a prescribed analgesic an hour prior to breastfeeding. D. Drink two glasses of water 30 minutes prior to breastfeeding. 10. A nurse is preparing to teach the parents of a child who had a surgical repair of myelomeningocele how to change an occlusive dressing on the child's back. Which statement by the parents indicates that they understand this procedure? A. "We should rapidly remove the tape from the edges of the dressing when changing it." B. "The dressing should be wetted periodically to keep the skin incision moist." C. "The dressing will help dry the sutures for ease of removal." D. " The purpose of the dressing is to protect the incision from fecal contamination." 11. While the nurse is preparing to administer a high volume saline enema to a male client, the client appears anxious and states that he is not able to turn on his right side without help because of a recent stroke. What action should the nurse take first? A. Reassure the client that he can remain in any position of comfort during the enema. B. Assess the client's ability to independently turn to his left side. C. Instruct the client that the procedure will only last about ten minutes. D. Ask a UAP to assist the client to maintain a right lateral position. 12. The nurse notes that a client is experiencing supraventricular tachyacardia (SVT). Which action should the nurse implement? A. Assess the client's heart sounds and vital signs. B. Call a code and start CPR immediately. C. Prepare to administer adenosine, an antidysrhythmic. D. Place a crash cart at the client's bedside. 13. A client is receiving an IV infusion of regular insulin, 50 units in 100 ml of normal saline at 4 units/ hour. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only.) 8 mL/hour 14 A client takes dronedarone (Multaq) 400 mg PO twice daily is admitted with chest pain and shortness of breath. The nurse should withhold the Multaq if the client manifests which finding? A. Three premature ventricular beats/minute. B. QTc interval less than 500 milliseconds. C. Respiratory rate greater than 30 beats/minute. D. Palpable radial pulse less than 50 beats/minute. 15. A middle-aged client with complaints of chest pain radiating into his jaw is en route to the hospital via ambulance. Oxygen was started, threee nitroglycerin sprays of 5 minute intervals were administered, with no pain relief, and an IV was initiated. The cardiac monitor indicates normal sinus rhythm. On arrival at the Emergency Department, which intervention should the nurse implement first? A. Prepare for defibrillation or cardioversion. B. Inject 5,000 units heparin subcutaneously C. Obtain a 12 lead EKG. D. Administer a chewable aspirin 325 mg. 16. The nurse is planning a fall prevention program for the residents at a long-term care facility. Which intervention is most important in providing a safe environment? A. Encourage clients to wear rubber-soled shoes. B. Accompany residents older than 80 years during ambulation. C. Apply a vest restraint prophylactically to confused residents. D. Leave the hall lights on during the night. 17. For a client who has been receiving linezolid (Zyvox) for two weeks to treat an MRSA- infected wounds, what finding requires the most immediate action by the nurse? A. Ecchymosis B. Insomnia C. Tongue discoloration D. Vaginal discharge 18. The unlicensed assistive personnel (UAP) caring for a postoperative client reports to the charge nurse that the client is not using the incentive spirometer effectively. What action should the charge nurse implement? A.Schedule time later in the morning to review the use of incentive spirometer with the client. B. Ask the practical nurse assigned to care for the client to review the use of spirometer with the client. C. Encourage the UAP to demonstrate the effective use of the incentive spirometer to the client. D. Advise the UAP that the respiratory therapist is responsible to supervise the client's use of the spirometer. 19. During discharge teaching the mother asks why her premature infant should get monthly Synagis (Palivizumab) injections. The nurse's response should be bsed on what information? A. Monthly injections promote normal neurological and physical development. B. This drug protects the premature infant from respiratory syncytial virus (RSV) C. These injections prevent retinopathy of prematurity caused by high levels of oxygen. D. This medication provides surfactant, which helps the lungs mature more quickly, 20. In preparing assignments for the shift, which client is best for the charge nurse to assign to a practical nurse? A. A client with panreatic cancer who is experiencing intractable pain. B. An older client who fell yesterday and is now complaining of diplopia. C. An adult newly diagnosed with Type 1 diabetes and high cholesterol. D. An elderly client with Alzeimer's disease complicated by dysphagia. 21. The RN is in charge of a 20-bed surgical unit and is preparing assignments for the shift. Which nursing task should be assigned to the LPN? A. Administer a unit of blood to a client who has decreased hemoglobin and hematocrit. B. Take the routine vital signs on a client who just returned from surgery. C. Teach a client who has a new sigmoid colostomy how to irrigate the colostomy. D. Administer a pain medication to a client who had a bowel resection yesterday. 22. Following the administration of total parenteral nutrition (TPN) via a central line to a client diagnosed with inflammatory bowel disease (IBD), the nurse should expect what outcome? A. Afebrile with no purulent drainage from catheter site. B. Hydration as evidenced by tented skin turgor. C. A weight loss of 6 pounds within two weeks. D. A negative nitrogen balance during TPN administration 23. What is the most important primary preventative measure the nurse can emphasize as a means of reducing the risk of developing acute glomerulonephritis in the general population? A. Encourage all persons to have a yearly physical with urinalysis B. Teach all females to seek medical attention for urinary tract infections. C. Use good handwashing techniques to prevent throat and skin infections. D. Eat a low salt diet and monitor the blood pressure frequently. 24. The culture and sensitivity report for a client who has been receiving a broad spectrum antibiotic indicated that the bacteria is resistant to the currently prescribed medication. What action should the nurse implement in response to this finding. A. Notify the lab of the need for drug peak and trough levels B. Determine if the white blood cell count has increased. C. Administer the next scheduled dose of the antibiotic. D. Assess the oral mucosa for signs of superinfection. 25. When the healthcare provider calls to check on the status of a client with congestive heart failure who was given IV furosemide (Lasix) four hours ago, the nurse reports that the client has bibasilar crackles. What additional information is most important for the nurse to report to the healthcare provider? The client: A. is taking ice chips B. is receiving intravenous fluids at 125 ml/hour C. is receiving 50% oxygen per venturi mask D. has had a urine output of 600 ml the past four hours. 26. In caring for a client who is receiving peritoneal dialysis, the nurse should be alert for what complications? A. Clear dialysate drainage and burning on urination. B. Abdominal pain, tenderness, and rigidity. C. An occluded vascular access device and flank pain. D. Increased serum albumin level, decreased BUN, and increased hematocrit. 27. The home care nurse observes an older client place the walker in front of the chair for support upon standing. What action should the nurse take? A. Observe the client's strength and balnce as she arises. B. Instruct the client to use the arms of the chair for support. C. Encourage the client to stand upright independently. D. Apply a gait belt to assess the client out of the chair. 28. An adult client being admitted to the psychiatric unit with a diagnosis of bipolar disorder arrives in an elated state. What is the best room assignmenrt the nurse can make for this client? A. A room that contain very little furniture B. A quiet room awat from the nurse's station C. A room that has at least two other clients assigned to it D. A bright-colored room located near the recreation room. 29. The nurse plans to place a sensor for a pulse oximeter. Which placement ensures the best measurement of oxygen saturation? A. Right upper extremity with 2+ pitting edema B. Left upper extremity with capillary refill 3 seconds C. Left lower extremity with a 3+ dorsalis pedis pulse D. Right lower extremity with a 1+ pedal pulse. 30. A client at 8 weeks gestation is told her hemoglobin is 9.5 mg/dl. Which nursing intervention has the highest priority? A. Explain tha this is a normal finding in early pregnancy. B. Instruct the client to eat a well-balanced diet. C. Probvide the client with a list of foods high in iron D. Obtain a prescription for an iron supplement. 31. The nurse is performing a routine well-child exam on a 5 year-old. While palpating the lymph nodes, the nurse feels several 0.5 cm nodes in the cervical area that are round, mobile, non-tender, and non warm to the touch. What do these findings most likely represent? A. An indicator of early stage mumps B. An expected finding for a well child of this age. C. A sign of acute lymphadenitis D. An abnormal finding in need of further investigation 32. An 86-year old female client complains to the nurse that she does not like to eat as much she used to because things taste differently to her now that she is olde. The nurse's response should be based on which fact? A. Taste sensation decreased in older adults because of diminished gastric secretions B. Older people often use poor taste sensation as an excuse to avoid eating foods they do not like. C. Poorly prepared meals and eating alone are the usual causes of a decreased appetite in older adults. D. A loss of appetite often occurs in older adults as a result of a decreased sense of smell. 33. The nurse is conducting health assessments. Which assessment finding increases a 56 year olf woman's risk for developing osteoporosis? A. Cigarrette smoking B. Family history of coronary heart disease C. Use of birth control pills until age 45 D. Obesity 34.The nurse is developing a teaching plan for a client with varicose veins. What instruction should be included in this plan? A. Soak feet in warm water when fatigues. B. Use elevators, instead of stairs C. Walk several minutes every hours D. Cross legs at the thighs only 35. The charge nurse in a critical care unit is reviewing client's conditions to determine who is stable enough to be transferred. Which client status report indicates readiness for transfer from the critical care unit to a medical unit? A. Myocradial infraction with sinus bradycardia and multiple ectopic beats B. End- stage renal failure with creatinine of 2.5 mg/dl and urinary output of 10 ml/hr C. Pulmonary embollus with an intravenous heparin infusion and new onset hematuria D. Adult respiratory distress with pulse oximetry of 88%