Edition Kacmarek | 9780323511124 | All Chapters with Ans
wers and Rationals
A nurse caring for a client who has an infected wound removes a dressing saturated with blood and p
urulent drainage. How should the nurse dispose of the dressing material?
A. Discard the dressing in the bedside trash receptacle.
B. Dispose of the dressing in a biohazardous waste container.
C. Enclose the dressing in a single clear plastic bag and discard in the bedside trash receptacle. - ANS
WER:B. Dispose of the dressing in a biohazardous waste container.
A nurse is caring for a female client who has recurrent kidney stones and is scheduled for an intraven
ous pyelogram. Which of the following statements should the nurse report to the provider?
A. "I drink at least 2 quarts of fluid every day."
B. "The last time I voided it was painful and red-tinged."
C. "My period ended 2 days ago."
D. "I don't eat shellfish because it gives me hives." - ANSWER:D. "I don't eat shellfish because it gives
me hives."
A nurse is preparing to administer 40 mEq of potassium chloride in 45% sodium chloride (NaCl) 500
mL IV to infuse 10 mEq/hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the
answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
CALCULATION - ANSWER:125 mL/hr
A nurse working for a home agency is assessing an older adult male client. Which of the following fin
dings is the priority for the nurse to address?
A. Swollen gums
B. Pruritus
,C. Urinary Hesitancy
D. Dysphagia - ANSWER:D. Dysphagia
A nurse is going to give a presentation about preventing deep-vein thrombosis (DVT). Which of the fo
llowing should the nurse include as a risk factor for this disorder? (Select all that apply.)
BMI of 20
Recent long flight
Hypertension
High calcium intake
Immobility - ANSWER:Flights
Immobility
A nurse is teaching a client who has a prescription of a nasogastric tube (NG) to treat a pyloric obstru
ction. Which of the following rationales for the use of the nasogastric tube should the nurse include i
n the teaching?
A. Determine the pH of the gastric secretions.
B. Supply nutrients via tube feedings.
C. Decompress the stomach.
D. Administer medications. - ANSWER:C. Decompress the stomach.
A nurse provides a back massage as a palliative care measure to a client who is unconscious, grimacin
g, and restless. Which of the following findings should the nurse identify as indicating a therapeutic r
esponse? (Select all that apply.)
The shoulders droop.
The facial muscles relax.
The respiratory rate increases.
The pulse is within the expected range.
The client draws his legs up into a fetal position. - ANSWER:The shoulders droop.
The facial muscles relax.
The pulse is within the expected range.
, A nurse is assessing a client who is postoperative and has anemia due to excess blood loss following s
urgery. Which of the following findings should the nurse expect?
A. Fatigue
B. Hypertension
C. Bradycardia
D. Diarrhea - ANSWER:A. Fatigue
A nurse is reviewing the arterial blood gas (ABG) results of a client who the provider suspects has me
tabolic acidosis. Which of the following results should the nurse expect to see?
A. pH below 7.35
B. HCO3 above 26 mEq/L
C. PaO2 below 70 mmHg
D. PaCO2 above 45 mmHg - ANSWER:A. pH below 7.35
A hospice nurse is reviewing the prescriptions for a client who is receiving palliative care. Which of th
e following prescriptions should the nurse expect? (Select all that apply.)
Provide skin care with a moisture barrier cream.
Administer artificial tear PRN.
Obtain vital signs every 2 hr.
Perform mouth care every hour.
Administer oxygen 2L/min via nasal cannula. - ANSWER:Provide skin care with a moisture barrier cre
am.
Administer artificial tear PRN.
Perform mouth care every hour.
Administer oxygen 2L/min via nasal cannula.
A nurse is planning care for a client who is postoperative and at risk of paralytic ileus. Which of the fo
llowing interventions should the nurse plan to take to promote peristalsis?