N480 Final Overview Questions and Answers
N480 Final Overview
Patient arrives at emergency dep with deep partial thickness burns RR; 26 bpm, nursing interventions SATA
- IV LR
- Admin morphine IV
- Admin tetanus prophylaxis as ordered
Low pressure alarm sound of vent, nurse assess and tries to determine the cause. Unsuccessful at determining
and takes what action
- Ventilate the client manually
Client admitted to ED with chest trauma. S/S that support pneumothorax
- Absent breath sounds
- Tachypnea
Nurse assessing cranial nerves, what could detect potential problem with cranial nerve 2
- Snellen chart
Nurse performing assessment and finds client has cool clammy skin P: 130, urine output of 20 ml per hour
- Decreased cardiac output and decreased tissue perfusion
Vitals of client with cardiac disease BP 104/76, P 53, RR 16. Atropine administered. What is therapeutic effect
of med
- Pulse rate increases to 76 bpm
Older adult client comes to ED with no appetite, N/V, on digitalis for more than a year, nursing action
- Obtain ECG, K+, and digoxin levels
Nurse admin atiplase tpa with pt with diagnosis of acute coronary syndrome. What is important implementation
- Place the client on bleeding precautions (atiplase is clot buster)
Nurse caring for client with cardiac cath 1 hour ago, nursing action
- Maintain pressure over catheter site and maintain circulation status
Nurse determines that client with diabetes is experiencing fat breakdown. What expect in urine
- Ketones
Nurse obtaining history, pt complaints of severe HA, nurse identifies following as modifiable rf for stroke
- Smoking
- Alcohol
- Decrease exercise
- Obesity
Pt comes into Er with midsternal chest pain radiating to neck unrelieved by nitro. What indicates to nurse to
identify MD
- ST segment elevation from the baseline
Nurse gives client morphine 2 mg IVP, nurse evaluated client. What is adverse effect
- RR of 8 breaths per minute
Nurse collecint info on group of lient experiencing renal disrders. Who should qualify for dialysis
- Cleint bleeding with minimal urine output
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, Nurse assessing cleinet with asthma. What is indicator of cyanosis?
- Oral mucosa
Math = 33 drops per min
Nurse caring for client who has diag of DM and HTN, started taking propanolol. Dizziness upon standing. What
nurse do?
- Monitor BP sitting and standing
Nurse admin desmopressin to pt with DI, what is therapeutic effect
- Increase in urine specific gravity (1.015)
Nurse caring for pt with burns to face, ears, eyelids. Priority to report
- Difficulty swallowing
Nurse in burn tx, pt admitted with burns to extremity. Escherotomy, client asks
- Large insicisons are made in eschar to improve circulation
Nurse teaching pt with acute renal failure about oliguric phase. Include
- Fluid output is less than 400 ml in 24 hours
Nurse planning low protein diet for pt with chronic enal failure. Why does pt have to be concerned
- Kidneys unable to rid the body of urea a waste product of protein
Talking with client with end stage liver disease. Pt unable to stay awake and falls asleep in convo.
- Increase in blood ammonia levels
Pt with massive trauma, spinal cord injuries. Finding confirming diagnosis of cardiogenic shock
- Apical heart rate of 44 beats per minute
Which finding is best indicator that fluid rescusitation has been successful for pt with hypovolemic shock
- UO is 16 ml for the last hour
Which assessment is most important for nurse to make whether the tx for pt with anaphylactic shock has been
effective
- Oxygen saturation
Received change of shift report, who does nurse assess
- Pt with smoke inhalation with wheezes and altered mental status
Dietary trays are walked to the nurse unit at 8 am, nurse should plan to admin intermediate acting insulin
- 6:30 and 7 am
Nurse monitorinf client with sever burn therapy. How know adequate fluid replacement
- Heart rate
Nurse planning care for client with end stage cirrhosis with encephalopathy. How to redue ammonia
- Reduce intake of protein
Nurse caring for adolescent with DM, admit to ER with acetone odor. DKA suspected. What insulin use
- Regular insulin
This study source was downloaded by 100000855457697 from CourseHero.com on 11-04-2022 02:42:11 GMT -05:00
https://www.coursehero.com/file/67250646/N480-Final-Overviewdocx/
N480 Final Overview
Patient arrives at emergency dep with deep partial thickness burns RR; 26 bpm, nursing interventions SATA
- IV LR
- Admin morphine IV
- Admin tetanus prophylaxis as ordered
Low pressure alarm sound of vent, nurse assess and tries to determine the cause. Unsuccessful at determining
and takes what action
- Ventilate the client manually
Client admitted to ED with chest trauma. S/S that support pneumothorax
- Absent breath sounds
- Tachypnea
Nurse assessing cranial nerves, what could detect potential problem with cranial nerve 2
- Snellen chart
Nurse performing assessment and finds client has cool clammy skin P: 130, urine output of 20 ml per hour
- Decreased cardiac output and decreased tissue perfusion
Vitals of client with cardiac disease BP 104/76, P 53, RR 16. Atropine administered. What is therapeutic effect
of med
- Pulse rate increases to 76 bpm
Older adult client comes to ED with no appetite, N/V, on digitalis for more than a year, nursing action
- Obtain ECG, K+, and digoxin levels
Nurse admin atiplase tpa with pt with diagnosis of acute coronary syndrome. What is important implementation
- Place the client on bleeding precautions (atiplase is clot buster)
Nurse caring for client with cardiac cath 1 hour ago, nursing action
- Maintain pressure over catheter site and maintain circulation status
Nurse determines that client with diabetes is experiencing fat breakdown. What expect in urine
- Ketones
Nurse obtaining history, pt complaints of severe HA, nurse identifies following as modifiable rf for stroke
- Smoking
- Alcohol
- Decrease exercise
- Obesity
Pt comes into Er with midsternal chest pain radiating to neck unrelieved by nitro. What indicates to nurse to
identify MD
- ST segment elevation from the baseline
Nurse gives client morphine 2 mg IVP, nurse evaluated client. What is adverse effect
- RR of 8 breaths per minute
Nurse collecint info on group of lient experiencing renal disrders. Who should qualify for dialysis
- Cleint bleeding with minimal urine output
This study source was downloaded by 100000855457697 from CourseHero.com on 11-04-2022 02:42:11 GMT -05:00
https://www.coursehero.com/file/67250646/N480-Final-Overviewdocx/
, Nurse assessing cleinet with asthma. What is indicator of cyanosis?
- Oral mucosa
Math = 33 drops per min
Nurse caring for client who has diag of DM and HTN, started taking propanolol. Dizziness upon standing. What
nurse do?
- Monitor BP sitting and standing
Nurse admin desmopressin to pt with DI, what is therapeutic effect
- Increase in urine specific gravity (1.015)
Nurse caring for pt with burns to face, ears, eyelids. Priority to report
- Difficulty swallowing
Nurse in burn tx, pt admitted with burns to extremity. Escherotomy, client asks
- Large insicisons are made in eschar to improve circulation
Nurse teaching pt with acute renal failure about oliguric phase. Include
- Fluid output is less than 400 ml in 24 hours
Nurse planning low protein diet for pt with chronic enal failure. Why does pt have to be concerned
- Kidneys unable to rid the body of urea a waste product of protein
Talking with client with end stage liver disease. Pt unable to stay awake and falls asleep in convo.
- Increase in blood ammonia levels
Pt with massive trauma, spinal cord injuries. Finding confirming diagnosis of cardiogenic shock
- Apical heart rate of 44 beats per minute
Which finding is best indicator that fluid rescusitation has been successful for pt with hypovolemic shock
- UO is 16 ml for the last hour
Which assessment is most important for nurse to make whether the tx for pt with anaphylactic shock has been
effective
- Oxygen saturation
Received change of shift report, who does nurse assess
- Pt with smoke inhalation with wheezes and altered mental status
Dietary trays are walked to the nurse unit at 8 am, nurse should plan to admin intermediate acting insulin
- 6:30 and 7 am
Nurse monitorinf client with sever burn therapy. How know adequate fluid replacement
- Heart rate
Nurse planning care for client with end stage cirrhosis with encephalopathy. How to redue ammonia
- Reduce intake of protein
Nurse caring for adolescent with DM, admit to ER with acetone odor. DKA suspected. What insulin use
- Regular insulin
This study source was downloaded by 100000855457697 from CourseHero.com on 11-04-2022 02:42:11 GMT -05:00
https://www.coursehero.com/file/67250646/N480-Final-Overviewdocx/
