Author: Anonymous

A client is admitted to the cardiac care unit with cardiogenic shock. The nurse assesses the client to be diaphoretic and tachypneic, with bilateral crackles throughout both lung fields. Following insertion of a pulmonary artery catheter, which hemodynamic values will the nurse most likely find?

The new medical-surgical floor nurse is rounding and finds the client in bed, sitting in high Fowler’s position. The client is using accessory muscles, is very anxious and has a feeling of impending doom. The client’s vital signs are: BP 90/50 mm/Hg, apical rate of 110 beats per minute, and RR of 36 shallow and labored. Which of the following should the nurse perform next?

The client is admitted to the ICU with acute respiratory failure and diabetic ketoacidosis (DKA). The following labs and blood gas (ABG) are obtained: ABG: pH 7.32, PaCO2 mmHg, HCO3 12 mEq/L, PaO2 58 mmHg, O2 Saturation 88% Hgb 10.4, HCT 32%, WBC 5.2 Bil/L, Platelets 150,000, lactate 1.2 mmol/L, Glucose 389 mg/dL, Creatinine 1.2 mg/dL The nurse interprets this ABG reading as ______________ _______ The nurse knows the cause of this ABG abnormality is a result of the client’s  _______ level.

The nurse is caring for a client who was just admitted to the ICU with an acute stroke. The client has a Glasgow Coma Scale (GCS) of 10 and is in high-fowler’s position with a non-rebreather mask connected to 100% oxygen. Which of the following nursing interventions is a priority in the client’s plan of care?

Match the nursing assessment with the cardiovascular condition. Each answer can only be used once.

The client is admitted with a musculoskeletal injury and the nurse suspects compartment syndrome. Which of the following is the initial manifestation that the nurse would observe with this condition?

The nurse is caring for a client who has undergone skin grafting of the face and arms for burn wound treatment. In creating a care plan for this client, which of the following nursing diagnosis would be a priority for this client?

The nurse is caring for a client with a chemical burn injury. The initial nursing intervention is to do which of the following?

The client was referred to the clinic due to increased abdominal girth and is diagnosed with ascites. After administering furosemide, which nursing action would be most effective in evaluating this treatment?

The nurse is caring for the client with COPD with: increasing work of breathing (WOB), RR of 26 and the following arterial blood gas (ABG): pH 7.29, PaCO2 62, PaO2 56, HCO3 30. Which of the following initial interventions would the nurse anticipate being ordered by the provider?