| A | B |
|---|
| 1. When a client's ventilation is impaired | the body retains which substance? |
| 5. A client has a serum calcium level of 7.2 mg/dl. During the physical examination | the nurse expects to assess: |
| a) pH 7.35 | PaCO2 40 mm Hg |
| *b) pH 7.49 | PaCO2 30 mm Hg |
| c) pH 7.44 | PaCO2 43 mm Hg |
| d) pH 7.38 | partial pressure of arterial carbon dioxide (PaCO2) 36 mm Hg |
| 7. A 73-year-old man comes into the emergency department (ED) by ambulance after slipping on a small carpet in his home. The patient fell on his hip with a resultant fracture. He is alert and oriented; PERRLA is intact. His heart rate is elevated | he is anxious and thirsty |
| c) The man has a brain injury | lacks antidiuretic hormone (ADH) |
| *d) He is having a sympathetic reaction | which has stimulated the renin-angiotensin-aldosterone system that results in diminished urine output. |
| 8. A client with pancreatic cancer has the following blood chemistry profile: Glucose | fasting: 204 mg/dl; blood urea nitrogen (BUN): 12 mg/dl; Creatinine: 0.9 mg/dl; Sodium: 136 mEq/L; Potassium: 2.2 mEq/L; Chloride: 99 mEq/L; CO2: 33 mEq/L. Which result should the nurse identify as critical and report immediately? |
| 10. To evaluate a client for hypoxia | the physician is most likely to order which laboratory test? |
| 11. A 64-year-old client is brought in to the clinic with thirsty | dry |
| 8a) No | sodium intake should be restricted. |
| b) Yes | this will correct the sodium deficit. |
| c) No | start with the sodium chloride IV. |
| d) Yes | along with the hypotonic IV. |
| 16. A patient with a diagnosis of colon cancer has undergone a bowel resection with the creation of an ileostomy. The patient's ileostomy output has been unexpectedly high in the 2 days since surgery | and the patient's most recent blood work indicates a K+ level of 2.7 mEq/L. This potassium level should prompt the nurse to assess for which of the following physical manifestations? |
| *a) Fatigue | cramps |
| b) Dysphagia | tetany |
| d) Shortness of breath | rales |
| 18. A client is taking spironolactone (Aldactone) to control her hypertension. Her serum potassium level is 6 mEq/L. For this client | the nurse's priority should be to assess her: |
| 20. A patient in the ICU starts complaining of being “short of breath.” An arterial blood gas (ABG) is drawn. The ABG has the following values: pH = 7.21 | PaCO2 = 64 mm Hg |
| 25. A nurse is caring for a client with metastatic breast cancer who is extremely lethargic and very slow to respond to stimuli. The laboratory report indicates a serum calcium level of 12.0 mg/dl | a serum potassium level of 3.9 mEq/L |
| 26. A nurse reviews the arterial blood gas (ABG) values of a client admitted with pneumonia: pH | 7.51; PaCO2 |
| 27. A client comes to the emergency department with status asthmaticus. His respiratory rate is 48 breaths/minute | and he is wheezing. An arterial blood gas analysis reveals a pH of 7.52 |
| 28. A client in the emergency department reports that he has been vomiting excessively for the past 2 days. His arterial blood gas analysis shows a pH of 7.50 | partial pressure of arterial carbon dioxide (PaCO2) of 43 mm Hg |
| 29. When evaluating arterial blood gases (ABGs) | which value is consistent with metabolic alkalosis? |
| 31. A client has the following arterial blood gas (ABG) values: pH | 7.12; partial pressure of arterial carbon dioxide (PaCO2) |
| 32. A client is brought in by ambulance in a nauseous and confused state and demonstrating carpopedal spasm. Initial arterial blood gases show increased pH and HCO3 and normal PaCO2 levels. Breathing is slow and shallow. As the nurse caring for this client | you know that potassium salt should be a part of the treatment for this client when? |
| 33. A client admitted with acute anxiety has the following arterial blood gas (ABG) values: pH | 7.55; partial pressure of arterial oxygen (PaO2) |
| 36. A 43-year-old patient with a history of alcohol abuse has been admitted to an acute medical unit with complications resulting from liver failure. Upon assessment | the patient's abdomen is distended |
| 44. To compensate for decreased fluid volume (hypovolemia) | the nurse can anticipate which response by the body? |
| 45. A patient's scheduled dose of furosemide (Lasix) 20 mg IV has recently finished infusing | and the nurse is preparing to administer metoclopramide (Reglan) 10 mg IV |
| 49. A 77-year-old woman with a diagnosis of congestive heart failure has experienced a downward trend in her hemoglobin levels in recent days | and her care team ordered the administration of two units of packed red blood cells. In the hours following her blood transfusion |
| d) Assessment of the patient's hemoglobin | hematocrit |
| 50. Maintaining fluid balance | especially in older adults |
| 53. Mr. R. is a 77-year-old patient admitted to the med/surg unit. He is awake and alert | but not oriented to time and place. His blood pressure is 108/64 |
| 54. You are assessing a 6-year-old little girl in the Emergency Department (ED) who was brought in by her mother. She was stung by a bee and is allergic to bee venom. The child is now having trouble breathing. She is vasodilated | hypotensive |
| a) Encouraging the family to leave the hospital and to take time for themselves | as care of MODS patients may last for months |
| d) Encouraging the family to stay hopeful and educate the family to the fact that | in most cases |
| 57. A 57-year-old client has been brought to your ED via squad. He is unresponsive and his wife is presenting his recent history. She reports his symptoms of elevated temperature and flushed skin. Physical assessment reveals a rapid | bounding pulse. The high school where the client is employed has had a significant increase in cases of staphylococcal and streptococcal infections among student athletes. His labs show an elevated WBC; cultures are forthcoming. What do you suspect may be the cause of the client's present condition? |
| 62. Industrial trauma resulted in the transport of a client to your ED. Enroute | his systolic BP was 98 and sinking. Which systolic BP supports the diagnosis of shock? |
| 71. A patient is being treated for renal calculi and suspected hydronephrosis. Therefore | the nurse should maintain a record of the kidney's function. Which of the following measures can the nurse take to help achieve the objective? |
| 76. The nurse is caring for an 84-year-old female patient who was brought to the emergency room by her daughter | who related that her mother has had very recent mental status changes and periods of incontinence. What condition should the nurse first suspect? |
| 77. A 49-year-old male patient has just had an ileostomy created as part of the treatment plan for bladder cancer. The nurse has begun the patient's discharge planning process and is creating an appropriate plan of care. When planning this patient's care | what psychosocial nursing diagnosis should the nurse most likely prioritize? |
| a) Void regularly | 5 to 8 times a day |
| 80. A 49-year-old man has been brought to the emergency department by his wife | who states that her husband is experiencing a repeat episode of kidneys stones. When planning interventions for this patient's immediate care |
