PN3 EXAM 3 QUESTIONS AND
ANSWERS
Which of the following interventions are appropriate for a client experiencing
hypovolemic shock (SATA)
A) Increase IV fluid delivery per order
B) Monitor vital signs
C) Monitor hemoglobin and hematocrit levels
D) Admin oxygen per protocol
What laboratory values does the nurse recognize as an indicatory of acute heart
injury?
Increase levels of myoglobin and Troponin
Which of the following actions would the nurse perform to assess the patency of
arteriovenous shunt site? (SATA)
A) Positive bruit
B) Palpable thrill
The nurse is planning care for a clients diagnosed with DIC. Which of the
following is priority?
Assess for clinical manifestations of hypoxia and decreased oxygen
A patient returning from the cardiac catheterization lab following an acute MI has
a slight increase in the following results: BUN 22 to 30; Creatinine 1.0 to 1.2; HGB
14 to 15.5; Glucose 89 to 95. Based on this information the nurse will anticipate
an order for which of the following interventions from the health care provider?
Administer a fluid bolus
A client diagnosed with chronic renal failure asked the nurse. "What the
difference between hemodialysis and peritoneal dialysis? Which of the following
statements best explain the difference?
Hemodialysis uses a graft or a fistula and pumps blood through a semipermeable
membrane in a hemodialyzer as the filter. Peritoneal dialysis uses the peritoneal lining
of the abdominal cavity as the filter.
When assessing a patient in shock, the nurse recognizes that the hemodynamics
of shock include?
Variations in cardiac output and decreased systemic vascular resistance in septic shock
The nurse is caring for a client with Addison's disease. Expected laboratory
findings would include which of the following?
Decreased cortisol levels, low fasting glucose, hyponatremia, hyperkalemia
A nurse in an emergency department is caring for a client who reports substernal
chest pain and dyspnea. The client is vomiting and diaphoretic. Which of the
following laboratory tests are used to diagnose a myocardial infarction?
Troponin I
, A nurse provides teaching to a client with a history of chronic stable angina and a
new prescription for nitroglycerin sublingual tablets. Which of the following
statements by the client indicates an understanding of the teaching for this
medication?
"I'll dial 911 and take three nitroglycerin tablets 5 minutes apart."
The client with chronic renal failure has been prescribes a restricted potassium
diet. Which of the following snacks is the most appropriate for the client?
Applesauce
The nurse is caring for a client with new onset of elevated BUN and creatinine,
oliguria, hypotension, and diarrhea for one week. The nurse suspects which
disease process?
Acute renal failure
A client presents with the following vital signs: BP 90/60, temp 38.3C (101F), HR
116, RR 24. The client has a post-op abdominal incision that is warm and red.
Which state of shock is this client in?
septic
The nurse place a client on telemetry following a diagnosis of anterior wall MI.
What findings are expected with this EKG tracing? (SATA)
A) ST segment elevation
B) An abnormal Q wave
D) T-wave inversion
A client is experiencing a bee sting before arrival to the emergency department
with difficulty breathing, a sign of hypoxia, and hypotension. The nurse realizes
these are signs of anaphylactic shock. Which of the following should the nurse
implement first?
Access the airway and apply oxygen per protocol
A client complains of weight gain, has thin extremities, a "buffalo hump," and a
protruding abdomen. The nurse realizes this client is most likely to be diagnosed
with which disease process?
Cushing's syndrome
A patient received tissue plasminogen activator (TPA) after a myocardial
infarction and now is on intravenous infusion of heparin. The patient's spouse
asks why the patient needs this medication. What response by the nurse is best?
The heparin keeps that artery from getting blocked again
A client is scheduled is scheduled for a left-sided femoral heart catheterization.
Which of the following should the nurse educate the client in preparation for this
diagnostic test?
The diagnostic test utilizes dye injected into the femoral blood vessel while X-Ray
images obtained
A nurse is caring for a client who has hypovolemic shock. Which of the following
should the nurse recognize as an expected finding?
Oliguria
Which of the following medications is a vasodilator administered sublingual and
absorbed through the mucus membrane?
Clopidogrel
What types of shock are included in distributive shock? (SATA)
ANSWERS
Which of the following interventions are appropriate for a client experiencing
hypovolemic shock (SATA)
A) Increase IV fluid delivery per order
B) Monitor vital signs
C) Monitor hemoglobin and hematocrit levels
D) Admin oxygen per protocol
What laboratory values does the nurse recognize as an indicatory of acute heart
injury?
Increase levels of myoglobin and Troponin
Which of the following actions would the nurse perform to assess the patency of
arteriovenous shunt site? (SATA)
A) Positive bruit
B) Palpable thrill
The nurse is planning care for a clients diagnosed with DIC. Which of the
following is priority?
Assess for clinical manifestations of hypoxia and decreased oxygen
A patient returning from the cardiac catheterization lab following an acute MI has
a slight increase in the following results: BUN 22 to 30; Creatinine 1.0 to 1.2; HGB
14 to 15.5; Glucose 89 to 95. Based on this information the nurse will anticipate
an order for which of the following interventions from the health care provider?
Administer a fluid bolus
A client diagnosed with chronic renal failure asked the nurse. "What the
difference between hemodialysis and peritoneal dialysis? Which of the following
statements best explain the difference?
Hemodialysis uses a graft or a fistula and pumps blood through a semipermeable
membrane in a hemodialyzer as the filter. Peritoneal dialysis uses the peritoneal lining
of the abdominal cavity as the filter.
When assessing a patient in shock, the nurse recognizes that the hemodynamics
of shock include?
Variations in cardiac output and decreased systemic vascular resistance in septic shock
The nurse is caring for a client with Addison's disease. Expected laboratory
findings would include which of the following?
Decreased cortisol levels, low fasting glucose, hyponatremia, hyperkalemia
A nurse in an emergency department is caring for a client who reports substernal
chest pain and dyspnea. The client is vomiting and diaphoretic. Which of the
following laboratory tests are used to diagnose a myocardial infarction?
Troponin I
, A nurse provides teaching to a client with a history of chronic stable angina and a
new prescription for nitroglycerin sublingual tablets. Which of the following
statements by the client indicates an understanding of the teaching for this
medication?
"I'll dial 911 and take three nitroglycerin tablets 5 minutes apart."
The client with chronic renal failure has been prescribes a restricted potassium
diet. Which of the following snacks is the most appropriate for the client?
Applesauce
The nurse is caring for a client with new onset of elevated BUN and creatinine,
oliguria, hypotension, and diarrhea for one week. The nurse suspects which
disease process?
Acute renal failure
A client presents with the following vital signs: BP 90/60, temp 38.3C (101F), HR
116, RR 24. The client has a post-op abdominal incision that is warm and red.
Which state of shock is this client in?
septic
The nurse place a client on telemetry following a diagnosis of anterior wall MI.
What findings are expected with this EKG tracing? (SATA)
A) ST segment elevation
B) An abnormal Q wave
D) T-wave inversion
A client is experiencing a bee sting before arrival to the emergency department
with difficulty breathing, a sign of hypoxia, and hypotension. The nurse realizes
these are signs of anaphylactic shock. Which of the following should the nurse
implement first?
Access the airway and apply oxygen per protocol
A client complains of weight gain, has thin extremities, a "buffalo hump," and a
protruding abdomen. The nurse realizes this client is most likely to be diagnosed
with which disease process?
Cushing's syndrome
A patient received tissue plasminogen activator (TPA) after a myocardial
infarction and now is on intravenous infusion of heparin. The patient's spouse
asks why the patient needs this medication. What response by the nurse is best?
The heparin keeps that artery from getting blocked again
A client is scheduled is scheduled for a left-sided femoral heart catheterization.
Which of the following should the nurse educate the client in preparation for this
diagnostic test?
The diagnostic test utilizes dye injected into the femoral blood vessel while X-Ray
images obtained
A nurse is caring for a client who has hypovolemic shock. Which of the following
should the nurse recognize as an expected finding?
Oliguria
Which of the following medications is a vasodilator administered sublingual and
absorbed through the mucus membrane?
Clopidogrel
What types of shock are included in distributive shock? (SATA)
