RN Comprehensive Online Practice
A bnurse bis bcaring bfor ba b5-year-old bchild
Physical bExamination:
1510:
Upon bvisual binspection, bthroat bis binflamed, btonsils bappear bpink, breddened band
bepiglottis bis bedematous band bcherry bred bin bappearance. bSkin bappears bpale.
bStridor bnoted bupon binspiration bwith bdiminished bbilateral blung bsounds.
Nurse's bNotes:
1500
Child baccompanied bto bemergency bdepartment bby bcaregiver. bCaregiver bstates bchild
bhas ba bsore bthroat band breports bthe bchild bhas b"pain bon bswallowing" band bdenies
bcough. bChild bis bagitated band blean b- bcorrect banswer. Condition: bEpiglottis
Actions: bInitiate bdroplet bprecautions band brequest ba bprescription bfor bIV bantibiotics
bMonitors: bBreath bsounds band btemperature
The bnurse bshould banticipate binitiating bdroplet bprecautions band brequesting ba
bprescription bfor bIV bantibiotics. bThe bchild bis bmost blikely bexperiencing bepiglottis
bbecause bof bthe bclinical bmanifestations bof ba bhigh bfever, binflammation band bredness
bof bthe bthroat, bpale bskin, bstridor bwith binspiration, bpainful bswallowing, bno bcough, bis
bsitting bin btripod bposition, band bdrooling. bThe bnurse bshould bmonitor bthe bchild's
btemperature band bbreath bsounds.
A bnurse bis bcaring bfor ba bclient bwho bis bon bthe bspinal bcord binjury b(SCI) bunit
Nurses' bNotes
bDay b3, b1700
Client badmitted bto bSCI bunit b3 bdays bago bfollowing bC7 binjury. bSkin bis bcool, bpale, band
bdry bto btouch. bRespirations beasy band bunlabored. bLung bsounds bdiminished bin blower
blobes.
Abdomen bsoft band bnondistended bwith bactive bbowel bsounds. bClient bpassed ba
bsmall bamount bof bhard bformed bstool bthis bAM. bIndwelling burinary bcatheter bdraining
bclear byellow burine. bDeep btendon breflexes b(DTR) bare bbiceps b1+, btriceps b1+, bpa b-
bcorrect banswer. The
bclient bis bmost blikely bexperiencing bmanifestations bof bpneumonia band bautonomic
bdysreflexia.
,The bnurse bshould banalyze bcues bfrom bthe bclient's bmanifestations band bdetermine
bthat bthe bclient bis bmost blikely bexperiencing bmanifestations bof bpneumonia band
bautonomic bdysreflexia. bA bclient bwho bhas ba bcervical bSCI bis bat brisk bfor brespiratory
bcomplications bbecause bspinal binnervation bto bthe brespiratory bmuscles bis bdisrupted.
bAdventitious bbreath bsounds bin bthe blower blobes bbilaterally band ba bdecrease bin
boxygen bsaturation bto bless bthan b92% bcan bindicate bpneumonia. bThe bclient's
bsudden bincrease bin bblood bpressure, bbradycardia, bflushing bof bthe bskin babove bthe
barea bof bthe binjury, bheadache, band bblurred bvision bare bmanifestations bof bautonomic
bdysreflexia, bwhich bcan bbe ba blife-threatening bcondition.
A bnurse bis bcaring bfor ba bclient bwho bhas babdominal bpain
Nurses' bNotes
b0900
Client breports bloss bof bappetite, bweight bloss, band bfatigue bfor b1 bweek. bReports
babdominal bpain, b6 bon ba bscale bfrom b0 bto b10, bfor b2 bdays. bClient bis ba
bperioperative bnurse, breturned b1 bweek bago bfrom ba b2-week bmission btrip bto ban
bunderdeveloped bcountry
1200
Results bof bantibody bstudies bobtained. bProvider bprescription bfor bantiviral bmedication
bpending.
Physical bExamination
b0930
Lung bsounds bclear bbilaterally. bSkin bwarm bto btouch band bjau b- bcorrect banswer.
Hepatitis
bA: bClient's brisk bfrom bfecal-oral btransmission, blaboratory bresults, band bphysical
bexamination bfindings
Hepatitis bB: bAntiviral btreatment, blaboratory bresults, bclient's brisk bfrom bbloodborne
btransmission, bphysical bexamination bfindings
Hepatitis bC: bAntiviral btreatment, blaboratory bresults, bclient's brisk bfrom bbloodborne
btransmission, band bphysical bexamination bfindings
When banalyzing bcues, bthe bnurse bshould brecognize bthat bmanifestations bof bhepatitis
bA, bhepatitis bB, band bhepatitis bC binclude bjaundice, byellow bsclerae, bright bupper
bquandrant bpain bupon bpalpation, bdark byellow burine, band belevated bAST band bALT
blevels. bWhen banalyzing bcues, bthe bnurse bshould balso brecognize bthe bclient's brisk
bfor bcontracting bhepatitis bA bthrough bthe bfecal-oral broute bduring brecent btravel bto ban
bunderdeveloped bcountry band bthe bclient's boccupational brisk bas ba bperioperative
bnurse bfor bcontracting bhepatitis bB band bhepatitis bC bthrough bbloodborne
btransmission. bThe bnurse bshould brecognize bthat bthe bcurrent bstandard bof bpractice
bfor
A bnurse bis bcaring bfor ba bclient bon ba bmedical-surgical bunit
,Vital bSigns
b0700
Temperature b37.6 bC b(99.7
bF) bHeart brate b100/min
bRespiratory brate b22/min
b Blood bpressure b115/70
bmmHg
Oxygen bsaturation b98% bon broom bair
Nurses' bNotes
b1100
Client balert band boriented bto bperson, bplace, band btime. bClient bhad bepisode bof
bdiarrhea, bprovided bperineal bcare. bNoted b2 bcm bx b2 bcm b(0.8 bin bx b0.8 bin) bpainful
bedematous barea bon bsacrum. bClient brepositioned bevery b4 bhr. b- bcorrect banswer.
Click bto bhighlight bthe
bfindings bthat brequire bfollow bup. bTo bdeselect ba bfinding, bclick bon bthe bfinding bagain.
- Noted b2 bcm bx b2 bcm b(0.8 bin bx b0.8 bin) bpainful bedematous barea bon bsacrum
- Client brepositioned bevery b4 bhr
When brecognizing bcues, bthe bnurse bshould bdetermine bthat bthe bclient's bpainful
bedematous barea bon btheir bsacrum band bthat bthe bclient bhas bonly bbeen brepositioned
bevery b4 bhr brequires bfollow bup. bThe bclient bhas bmanifestations bof ba bpressure binjury
bthat bneed bto bbe baddressed. bThe bclient bshould bbe brepositioned bat bleast bevery b2
bhr bto bprevent bworsening bof bthe bpressure binjury band bto brelieve bpressure bfrom bthe
bsacral barea.
A bnurse bin ban boutpatient bmental bhealth bclinic bis bcaring bfor ba bclient
Vital bSigns
3 bmonths bago
Blood bpressure b116/68
bmmHg bHeart brate b82/min
b Respiratory brate b16/min
bTemperature b36.7 bC b(98.1
bF) bSaO2 b97% bon broom bair
Today:
Blood bpressure b128/76
bmmHg bHeart brate b104/min
bRespiratory brate b22/min
bTemperature b37.4 b(99.4 bF)
bSaO2 b97% bon broom bair
Nurses' bNotes
b3 bmonths
bago
Client brecently badmitted bwith bnew bdiagnosis bof bschizophrenia. bReceived binpatient
btreatment bfor b10 bdays band bwas bdischarged b1 bweek bago. b- bcorrect banswer.
Select bthe
b3 bfindings bthat brequire bimmediate bfollow bup:
- Auditory bhallucinations
, - Speech
- Restlessness
When brecognizing bcues, bthe bnurse bshould bidentify bthat bthe bfindings bof
brestlessness, bauditory bhallucinations, band bpressured bspeech brequire bimmediate
bfollow bup. bThese bfindings bare bindications bof bpsychosis. bThe bnurse bshould bnotify
bthe bprovider bfor badditional bevaluation band btreatment.
A bnurse bis bcaring bfor ba bclient bwho bis bpostoperative bfollowing bcoronary bartery
bbypass bsurgery b(CABG)
Laboratory
bResults b0630
Sodium b145 bmEq/L b(136 bto b145
bmEq/L) bPotassium b3.2 bmEq/L b(3.5 bto
b5 bmEq/L) bChloride b116 bmEq/L b(98 bto
b106 bmEq/L) bBUN b24 bmg/dL b(10 bto
b20 bmg/dL) bMagnesium b1.5 bmEq/L b(1.3
bto b2.1 bmEq/L) bTotal bcalcium b9 bmg/dL
b(9 bto b10.5 bmg/dL) bPhosphate b4.6
bmg/dL b(3 bto b4.5 bmg/dL) bGlucose b95
bmg/dL b(74 bto b106 bmg/dL)
WBC bcount b9,500/mm3 b(5,000 bto b10,000/mm3)
I b& bO
b0700
4 bhr binput b400 bmL
4 bhr boutput b- bcorrect banswer. The bclient bis bat bgreatest brisk bfor bdeveloping
bdysrhythmias, bas bevidenced bby belectrolyte bimbalance.
The bnurse bshould banalyze bcues bto bdetermine bthe bclient bis bat bgreatest brisk bfor
bdeveloping bdysrhythmias brelated bto bhypokalemia, bas bevidenced bby bthe blaboratory
breport band bthe bclient's breport bof bmuscle bcramping. bPotassium band bmagnesium
bdepletion bare bcommon bmanifestations bin bclients bwho bare bpostoperative bfollowing
bCABG. bDue bto bmedication bor bhemodilation, bit bis bimportant bfor bthe bnurse bto bclosely
bmonitor belectrolytes.
A bnurse bis bcaring bfor ba bclient bwho bis bpregnant bin bthe bacute bcare bsetting
Nurses' bNotes
b1400
Client breports ba bconstant blow bdull bbackache band bpainless babdominal btightening bfor
bthe bpast b3 bhr. bDenies bany bchanges bin bvaginal bdischarge. bExternal bfetal bmonitor
bapplied.
1430
Contraction bpattern: bcontractions bevery b4 bto b5 bmin, blasting b30 bto b45 bseconds,
bpalpate bmild bin bintensity
A bnurse bis bcaring bfor ba b5-year-old bchild
Physical bExamination:
1510:
Upon bvisual binspection, bthroat bis binflamed, btonsils bappear bpink, breddened band
bepiglottis bis bedematous band bcherry bred bin bappearance. bSkin bappears bpale.
bStridor bnoted bupon binspiration bwith bdiminished bbilateral blung bsounds.
Nurse's bNotes:
1500
Child baccompanied bto bemergency bdepartment bby bcaregiver. bCaregiver bstates bchild
bhas ba bsore bthroat band breports bthe bchild bhas b"pain bon bswallowing" band bdenies
bcough. bChild bis bagitated band blean b- bcorrect banswer. Condition: bEpiglottis
Actions: bInitiate bdroplet bprecautions band brequest ba bprescription bfor bIV bantibiotics
bMonitors: bBreath bsounds band btemperature
The bnurse bshould banticipate binitiating bdroplet bprecautions band brequesting ba
bprescription bfor bIV bantibiotics. bThe bchild bis bmost blikely bexperiencing bepiglottis
bbecause bof bthe bclinical bmanifestations bof ba bhigh bfever, binflammation band bredness
bof bthe bthroat, bpale bskin, bstridor bwith binspiration, bpainful bswallowing, bno bcough, bis
bsitting bin btripod bposition, band bdrooling. bThe bnurse bshould bmonitor bthe bchild's
btemperature band bbreath bsounds.
A bnurse bis bcaring bfor ba bclient bwho bis bon bthe bspinal bcord binjury b(SCI) bunit
Nurses' bNotes
bDay b3, b1700
Client badmitted bto bSCI bunit b3 bdays bago bfollowing bC7 binjury. bSkin bis bcool, bpale, band
bdry bto btouch. bRespirations beasy band bunlabored. bLung bsounds bdiminished bin blower
blobes.
Abdomen bsoft band bnondistended bwith bactive bbowel bsounds. bClient bpassed ba
bsmall bamount bof bhard bformed bstool bthis bAM. bIndwelling burinary bcatheter bdraining
bclear byellow burine. bDeep btendon breflexes b(DTR) bare bbiceps b1+, btriceps b1+, bpa b-
bcorrect banswer. The
bclient bis bmost blikely bexperiencing bmanifestations bof bpneumonia band bautonomic
bdysreflexia.
,The bnurse bshould banalyze bcues bfrom bthe bclient's bmanifestations band bdetermine
bthat bthe bclient bis bmost blikely bexperiencing bmanifestations bof bpneumonia band
bautonomic bdysreflexia. bA bclient bwho bhas ba bcervical bSCI bis bat brisk bfor brespiratory
bcomplications bbecause bspinal binnervation bto bthe brespiratory bmuscles bis bdisrupted.
bAdventitious bbreath bsounds bin bthe blower blobes bbilaterally band ba bdecrease bin
boxygen bsaturation bto bless bthan b92% bcan bindicate bpneumonia. bThe bclient's
bsudden bincrease bin bblood bpressure, bbradycardia, bflushing bof bthe bskin babove bthe
barea bof bthe binjury, bheadache, band bblurred bvision bare bmanifestations bof bautonomic
bdysreflexia, bwhich bcan bbe ba blife-threatening bcondition.
A bnurse bis bcaring bfor ba bclient bwho bhas babdominal bpain
Nurses' bNotes
b0900
Client breports bloss bof bappetite, bweight bloss, band bfatigue bfor b1 bweek. bReports
babdominal bpain, b6 bon ba bscale bfrom b0 bto b10, bfor b2 bdays. bClient bis ba
bperioperative bnurse, breturned b1 bweek bago bfrom ba b2-week bmission btrip bto ban
bunderdeveloped bcountry
1200
Results bof bantibody bstudies bobtained. bProvider bprescription bfor bantiviral bmedication
bpending.
Physical bExamination
b0930
Lung bsounds bclear bbilaterally. bSkin bwarm bto btouch band bjau b- bcorrect banswer.
Hepatitis
bA: bClient's brisk bfrom bfecal-oral btransmission, blaboratory bresults, band bphysical
bexamination bfindings
Hepatitis bB: bAntiviral btreatment, blaboratory bresults, bclient's brisk bfrom bbloodborne
btransmission, bphysical bexamination bfindings
Hepatitis bC: bAntiviral btreatment, blaboratory bresults, bclient's brisk bfrom bbloodborne
btransmission, band bphysical bexamination bfindings
When banalyzing bcues, bthe bnurse bshould brecognize bthat bmanifestations bof bhepatitis
bA, bhepatitis bB, band bhepatitis bC binclude bjaundice, byellow bsclerae, bright bupper
bquandrant bpain bupon bpalpation, bdark byellow burine, band belevated bAST band bALT
blevels. bWhen banalyzing bcues, bthe bnurse bshould balso brecognize bthe bclient's brisk
bfor bcontracting bhepatitis bA bthrough bthe bfecal-oral broute bduring brecent btravel bto ban
bunderdeveloped bcountry band bthe bclient's boccupational brisk bas ba bperioperative
bnurse bfor bcontracting bhepatitis bB band bhepatitis bC bthrough bbloodborne
btransmission. bThe bnurse bshould brecognize bthat bthe bcurrent bstandard bof bpractice
bfor
A bnurse bis bcaring bfor ba bclient bon ba bmedical-surgical bunit
,Vital bSigns
b0700
Temperature b37.6 bC b(99.7
bF) bHeart brate b100/min
bRespiratory brate b22/min
b Blood bpressure b115/70
bmmHg
Oxygen bsaturation b98% bon broom bair
Nurses' bNotes
b1100
Client balert band boriented bto bperson, bplace, band btime. bClient bhad bepisode bof
bdiarrhea, bprovided bperineal bcare. bNoted b2 bcm bx b2 bcm b(0.8 bin bx b0.8 bin) bpainful
bedematous barea bon bsacrum. bClient brepositioned bevery b4 bhr. b- bcorrect banswer.
Click bto bhighlight bthe
bfindings bthat brequire bfollow bup. bTo bdeselect ba bfinding, bclick bon bthe bfinding bagain.
- Noted b2 bcm bx b2 bcm b(0.8 bin bx b0.8 bin) bpainful bedematous barea bon bsacrum
- Client brepositioned bevery b4 bhr
When brecognizing bcues, bthe bnurse bshould bdetermine bthat bthe bclient's bpainful
bedematous barea bon btheir bsacrum band bthat bthe bclient bhas bonly bbeen brepositioned
bevery b4 bhr brequires bfollow bup. bThe bclient bhas bmanifestations bof ba bpressure binjury
bthat bneed bto bbe baddressed. bThe bclient bshould bbe brepositioned bat bleast bevery b2
bhr bto bprevent bworsening bof bthe bpressure binjury band bto brelieve bpressure bfrom bthe
bsacral barea.
A bnurse bin ban boutpatient bmental bhealth bclinic bis bcaring bfor ba bclient
Vital bSigns
3 bmonths bago
Blood bpressure b116/68
bmmHg bHeart brate b82/min
b Respiratory brate b16/min
bTemperature b36.7 bC b(98.1
bF) bSaO2 b97% bon broom bair
Today:
Blood bpressure b128/76
bmmHg bHeart brate b104/min
bRespiratory brate b22/min
bTemperature b37.4 b(99.4 bF)
bSaO2 b97% bon broom bair
Nurses' bNotes
b3 bmonths
bago
Client brecently badmitted bwith bnew bdiagnosis bof bschizophrenia. bReceived binpatient
btreatment bfor b10 bdays band bwas bdischarged b1 bweek bago. b- bcorrect banswer.
Select bthe
b3 bfindings bthat brequire bimmediate bfollow bup:
- Auditory bhallucinations
, - Speech
- Restlessness
When brecognizing bcues, bthe bnurse bshould bidentify bthat bthe bfindings bof
brestlessness, bauditory bhallucinations, band bpressured bspeech brequire bimmediate
bfollow bup. bThese bfindings bare bindications bof bpsychosis. bThe bnurse bshould bnotify
bthe bprovider bfor badditional bevaluation band btreatment.
A bnurse bis bcaring bfor ba bclient bwho bis bpostoperative bfollowing bcoronary bartery
bbypass bsurgery b(CABG)
Laboratory
bResults b0630
Sodium b145 bmEq/L b(136 bto b145
bmEq/L) bPotassium b3.2 bmEq/L b(3.5 bto
b5 bmEq/L) bChloride b116 bmEq/L b(98 bto
b106 bmEq/L) bBUN b24 bmg/dL b(10 bto
b20 bmg/dL) bMagnesium b1.5 bmEq/L b(1.3
bto b2.1 bmEq/L) bTotal bcalcium b9 bmg/dL
b(9 bto b10.5 bmg/dL) bPhosphate b4.6
bmg/dL b(3 bto b4.5 bmg/dL) bGlucose b95
bmg/dL b(74 bto b106 bmg/dL)
WBC bcount b9,500/mm3 b(5,000 bto b10,000/mm3)
I b& bO
b0700
4 bhr binput b400 bmL
4 bhr boutput b- bcorrect banswer. The bclient bis bat bgreatest brisk bfor bdeveloping
bdysrhythmias, bas bevidenced bby belectrolyte bimbalance.
The bnurse bshould banalyze bcues bto bdetermine bthe bclient bis bat bgreatest brisk bfor
bdeveloping bdysrhythmias brelated bto bhypokalemia, bas bevidenced bby bthe blaboratory
breport band bthe bclient's breport bof bmuscle bcramping. bPotassium band bmagnesium
bdepletion bare bcommon bmanifestations bin bclients bwho bare bpostoperative bfollowing
bCABG. bDue bto bmedication bor bhemodilation, bit bis bimportant bfor bthe bnurse bto bclosely
bmonitor belectrolytes.
A bnurse bis bcaring bfor ba bclient bwho bis bpregnant bin bthe bacute bcare bsetting
Nurses' bNotes
b1400
Client breports ba bconstant blow bdull bbackache band bpainless babdominal btightening bfor
bthe bpast b3 bhr. bDenies bany bchanges bin bvaginal bdischarge. bExternal bfetal bmonitor
bapplied.
1430
Contraction bpattern: bcontractions bevery b4 bto b5 bmin, blasting b30 bto b45 bseconds,
bpalpate bmild bin bintensity
