Category: Uncategorized

A client has eaten strawberries and is experiencing anaphylactic reaction.  An epinephrine injection has been given.  Which of the following assessment findings best indicates that the medication is effective?      

The client experiencing an anaphylactic reaction may experience which of the following signs and symptoms? Select All That Apply 1.  Bradycardia 2.  Laryngeal Edema 3.  Pallor 4.  Dyspnea 5.  Bronchospasm

A nurse is completing a nutritional status assessment of a client with AIDS-related complications.  What are the priority components for the nurse to include in this assessment. Select All That Apply 1.  Serum Albumin Level 2.  Weight history 3.  Platelet Count 4.  Body Mass Index 5.  White Blood Cell Count

The nurse observes a constant bubbling in the water-seal column of a water-seal chest drainage system.   The nurse’s best priority intervention would be to:                                                                                       

A client reports that he has received the Bacilli- Calmette- Guerin (BCG) vaccination.  Which of the following is the best method to determine the client’s  tuberculosis (TB) status?              

 Which nursing intervention is the highest priority during the first twenty-four (24)  hours postoperatively for the client who had a total laryngectomy due to cancer of the larynx?                                            

The nurse is teaching a patient/client about the inhaler:   Combination med salmeterol/fluticasone.    Which statements by the patient indicate a correct understanding of this medication?  SELECT ALL THAT APPLY         “I will be sure to rinse my mouth with water after each dose.”         “I need to use this inhaler whenever I feel short of breath.”         “This medication is taken twice every day, every 12 hours.”                 “I can take this inhaler if I get short of breath while exercising.”          “I will call my healthcare provider if I notice white patches inside my mouth.”

The nurse is assessing a client with hypoxemia of unknown cause.  Which of the following assessment findings directly relate to the perfusion of oxygen and presence of circulating oxygen in the body? Select All That Apply 1.  PaO2 of 88mmHg 2.  B.P.  120/80 3.  Hemoglobin of 13.0 g/dL 4.  SpO2  97% 5.  NA  140 mEq/L

The nurse is completing a focused assessment addressing a patient’s immune function.  What should the nurse prioritize in the physical assessment?    

The nurse is reviewing the medical history of a client who is about to receive therapy with etanercept.  Which conditions, if present would be  a contraindication or caution for therapy with etanercept? Select All That Apply 1.  Psoriasis 2.  Urinary Tract Infections 3.  A person with Congestive Heart Failure 4.  A person receiving a corticosteroid 5.  A person with a Latex Allergy