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Amhomemhealthmnursemismevaluatingmamschool-
agemchildmwhomhasmcysticmfibrosis.mThemnursemshouldminitiatemamrequestmformhigh-
frequencymchestmcompressionmvestminmresponsemtomwhichmofmthemfollowingmparentmstatements?
"Mymchildmdoesn'tmlikemtomsitmstillmformnebulizermtreatments."
"Imthinkmthatmmymchildmhasmbeenmrunningmamfevermovermthemlastmcouplemofmdays."
"Mymchildmhasmonlymamsmallmamountmofmmucusmaftermpercussionmtherapy."
"Imammconcernedmaboutmmymchild'smfuturemparticipationminmteammsports."m-
mCORRECTmANSWERm"Mymchildmhasmonlymamsmallmamountmofmmucusmaftermpercussionmtherapy."
Amnursemismcaringmformamclientmwhomhasmtypem1mdiabetesmmellitusmandmreportsmseveremanklempain
maftermfallingmoffmamstepstoolmatmhome.mWhichmofmthemfollowingmprescriptionsmshouldmthemnursemc
larifymwithmthemprovider?
Obtainmcapillarymbloodmglucosemlevelmeverym2mhr.
Checkmthemneurovascularmstatusmofmthemclient'smlowermextremitiesmeverymhour.
Applymamcoldmpackmtomthemclient'smanklemform30mminmeverymhour.
Maintainmthemaffectedmanklemelevatedmandmimmobilized.m-
mCORRECTmANSWERmApplymamcoldmpackmtomthemclient'smanklemform30mminmeverymhour.
Amnursemismassessingmamnewbornmwhomism2mhrmold.mWhichmofmthemfollowingmfindingsmshouldmthemn
ursemreportmtomthemprovider?
,Slightlymbluemhandsmandmfeet
Respiratorymratem40/min
Axillarymtemperaturem36.2Cm(97.2F)
Apicalmpulsem136/minm-mCORRECTmANSWERmAxillarymtemperaturem36.2Cm(97.2F)
Amnursemismcaringmformamclientmwhomism3mdaysmpostoperativemfollowingmamT4mspinalmcordminjury.m
Dragm1mconditionmandm1mclientmfindingmtomfillminmthemblankminmthemfollowingmsentence.m
Themclientmismatmriskmformdevelopingm____mduemtom____.m-
mCORRECTmANSWERmThemclientmismatmriskmformdevelopingmHEMORRHAGICmSTROKEmduemtomAUTO
NOMICmDYSREFLEXIA.
Amnursemismcaringmformamschool-agemchild.m
Formeachmassessmentmfinding,mclickmtomspecifymifmthemfindingmismconsistentmwithmattentionmdeficitm
hyperactivitymdisorderm(ADHD)mormintellectualmdisabilitym(ID).mEachmfindingmmaymsupportmmoremt
hanm1mdiseasemprocess.m-mCORRECTmANSWERmADHD-
mHyperreactivitymtomsensoryminput,mInterruptingmothers,mLosingmnecessarymthings,mIntellectualmim
pairment
ID-mImpairedmlanguagemskills,mIntellectualmimpairment
Amnursemismcaringmformamnewlymadmittedmclient.
Selectm2mfindingsmthatmrequiremimmediatemfollow-up.m-mCORRECTmANSWERmHemoglobin
Plateletmcount
,Amnursemismcaringmformamnewborn.m
Completemthemfollowingmsentencembymusingmthemlistmofmoptions.
Themnursemshouldmplanmtomfirstmassessmthemnewborn'sm______followedmbymthemnewborn's______
_.m-
mCORRECTmANSWERmThemnursemshouldmplanmtomfirstmassessmthemnewborn'smRESPIRATORYmRATEmf
ollowedmbymthemnewborn'smHEARTmRATE.
Amnursemismcaringmformamclientmwhomism24mhrmpostoperativemfollowingmamcesareanmbirth.m
Dragm1mconditionmandm1mclientmfindingmtomfillminmthemblankminmthemfollowingmsentence.m
Themclientmismatmriskmformdevelopingm____masmevidencedmbym_____.m-
mCORRECTmANSWERmThemclientmismatmriskmformdevelopingmSEIZURESmasmevidencedmbymBLOODmPRE
SSURE.
Amnursemonmammedical-
surgicalmunitmismcaringmformamclientmwhomismpostoperativemfollowingmanmemergencymappendectom
y.
Completemthemdiagram.m-mCORRECTmANSWERmPotentialmcondition:m
Varicosemveins
Actionsmtomtake:m
Elevatemthemextremity
Applymgraduatedmcompressionmstockings
, Parametersmtommonitor:
Edemamofmrightmlowermextremitym
Pruritismofmrightmlowermextremity
Amnursemonmammentalmhealthmunitmismcaringmformamclient.m
Formeachmpotentialmprovider'smprescription,mclickmtomspecifymifmthempotentialmprescriptionmismantic
ipatedmormcontraindicated.m-mCORRECTmANSWERmAnticipated:m
Initiatemsuicidemprecautions
Potassiumm40mmEqmPOmdaily
Contraindicated:
Low-sodiummdiet
Fluoxetinem20mmgmPOmdaily
Amnursemismcaringmformamclientminmthememergencymdepartmentm(ED).
Themnursemismplanningmcaremformthemclient.mSelectmthem5mactionsmthemnursemshouldmplanmtomtake.m
-mCORRECTmANSWERm-PerformmamClinicalmInstitutemWithdrawalmAssessmentmformAlcoholm(CIWA-
Ar)
-Initiatemseizuremprecautionsm
-Administermchlordiazepoxide
-Administermthiamine
-Maintainmamlow-stimulationmenvironment
Amnursemismcaringmformamclientminmtheminpatientmpsychiatricmunit.