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NEW QUESTION # 68
The priority nursing diagnosis for a hospitalized patient with a Stage IV pressure ulcer on the hip would be:
- A. Altered nutrition
- B. Risk for infection
- C. Altered body image
- D. Acute pain
Answer: B
NEW QUESTION # 69
While preparing the midday medications, the nurse finds difficulty reading the label on a medicine bottle. The best action by the nurse is to:
- A. Make out a new label with clear handwriting using adhesive tape to attach it
- B. Ask the pharmacist to replace it with a clearly labeled bottle
- C. Give the medication if it is similar to a bottle present on the trolley
- D. Document that it could not be given due to difficulty in reading the label
Answer: B
NEW QUESTION # 70
A patient undergoes laminectomy. In the immediate post-operative period, the nurse shoulD.
- A. Monitor the patient's vital signs, check sensation and motor power of the feet
- B. Monitor the patient's vital signs and encourage him to ambulate
- C. Monitor the patient's vital signs and log roll him to prone position
- D. Monitor the patient's vital signs and auscultate his bowel sounds
Answer: A
NEW QUESTION # 71
The nurse notes that there are no physician's orders regarding Fatima's post operative daily insulin dose. The most appropriate action by the nurse is to:
- A. Give the patient her usual daily insulin dose since the stress of surgery will increase her blood glucose
- B. Call the physician to clarify whether insulin should be given and at what dose
- C. Give half the usual daily insulin dose since she will not be eating in the morning
- D. Withhold any insulin dose since none is ordered and the patient is NPO
Answer: B
NEW QUESTION # 72
Which of the following laboratory blood values is expected to be decreased in hepatic dysfunction?
- A. Ammonia
- B. Bilirubin
- C. Albumin
- D. ALT and AST
Answer: C
NEW QUESTION # 73
A patient becomes angry and threatens to leave the hospital unless the physician reviews the reason for the patient's delay in discharge. The patient has a medication order for agitation available p.m.. but refuses the medication and requests a drink of orange juice instead. What should the nurse do?
- A. Inform the patient that staff is unable to force anyone to stay in the hospital
- B. Give the patient the orange juice and tell the patient that a staff member is attempting to call the physician
- C. Secretly slip the p.r.n. medication into the orange juice and give it to the patient
- D. Inform the patient that nothing can be done until the morning
Answer: B
NEW QUESTION # 74
A nurse can ensure she maintains her competency to practice through:
- A. Making sure that what was learnt at nursing school is strictly followed
- B. Working on the same ward for at least 2 years
- C. Being involved in continuing education programs
- D. Closely carrying out instructions given by the Charge Nurse
Answer: C
NEW QUESTION # 75
The patient is to receive 100 ml/hr of D5W through a micro drip. How many drops per minute should the patient receive?
- A. 25 gtts/min
- B. 100 gtts/min
- C. 30 gtts/min
- D. 200 gtts/min
Answer: B
NEW QUESTION # 76
To promote accuracy of self-monitoring blood glucose by patients the nurse should:
- A. Compare results from patient's meter against lab results
- B. Retrain patients periodically
- C. Direct patients to rotate testing sites
- D. Advise patients to buy new strips routinely
Answer: B
NEW QUESTION # 77
After application of a cast in the upper extremity, the patient complains of severe pain in the affected site. Which of the following would the nurse initiate?
- A. Pad the edges of the cast
- B. Notify his physician
- C. Assess neurovascular status
- D. Administer analgesics as ordered
Answer: C
NEW QUESTION # 78
The apical pulse can be best auscultated at the:
- A. Left 2nd intercostal space at the left sternal border
- B. Left 5th intercostal space at the mid axillary line
- C. Left 2nd intercostal space lateral to the mid clavicular line
- D. Left 5th intercostal space at the mid clavicular line
Answer: D
NEW QUESTION # 79
A patient requires tracheal suctioning through the nose. Which of the following nursing action would be incorrect?
- A. Applying suction for a minimum of 30 seconds
- B. Applying suction while withdrawing the catheter from the nose
- C. Rotating the catheter while withdrawing it
- D. Lubricating the catheter with sterile water
Answer: A
NEW QUESTION # 80
A patient arrived to the Post Anesthesia Care Unit (PACU) complaining of pain after undergoing a right total hip arthroplasty. Which of the following should the nurse do to assess the patient's level of pain?
- A. Inspect the dressing, note type and amount of drainage, and insure bandage adhesive is not pulling on skin
- B. Note location, intensity and duration of pain and last dose and time of pain medication
- C. Ask anesthesiologist what type of anesthesia patient received and last dose of pain medication
- D. Determine the patient's position during surgery and how long the patient was in this position
Answer: B
NEW QUESTION # 81
A patient has been taking Aluminum Hydroxide daily for 3 weeks. The nurse should be alert for which of the following side effects?
- A. Flatulence
- B. Constipation
- C. Nausea
- D. Vomiting
Answer: B
NEW QUESTION # 82
The urinary catheter is kept securely in the bladder by:
- A. Anchoring the catheter bag to the bed
- B. Securing catheter and collection bag connections
- C. Inflating the balloon of the catheter
- D. Taping the urinary catheter to the leg
Answer: C
NEW QUESTION # 83
The physician orders heparin 40 000 U in 1 liter of D5W IV to infuse at 1000 U/hr. What is the flow rate in milliliters per hour?
- A. 2.5 mls/hr
- B. 250 mls/hr
- C. 25 mls/hr
- D. 0.25 mls/hr
Answer: C
NEW QUESTION # 84
To ensure safe practice during defibrillation, the nurse must:
- A. Synchronize prior to shock delivery
- B. Cover paddles with electrode gel
- C. Remove paddles after the shock
- D. Avoid touching the patient's bed
Answer: D
NEW QUESTION # 85
The nurse should suspect that a patient has bleeding in the upper gastrointestinal tract when the color of the patient's stool is:
- A. Black
- B. Clay
- C. Red
- D. Yellow
Answer: A
NEW QUESTION # 86
A patient is to receive 25mg/hr of an aminophylline infusion. The solution prepared by the pharmacy contains 500mg of aminophylline in 1000ml of D5W. How many milligrams are available per ml?
- A. 2 mg/ml
- B. 0.25 mg/ml
- C. 0.5 mg/ml
- D. 1 mg/ml
Answer: C
NEW QUESTION # 87
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