Nursing 450 Final Exam Questions and Answers Latest 2023, Exams of Nursing

Download Nursing 450 Final Exam Questions and Answers Latest 2023 and more Exams Nursing in PDF only on Docsity! Nursing 450 Final Exam Questions and Answers Latest 2023. 1. The nurse is caring for a client who has increased intracranial pressure. Which of the nursing interventions by the nurse is appropriate? a. Teach controlled coughing and deep breathing b. Provide a brightly lit environment c. Elevate the head of the bed 30 degrees d. Encourage minimum intake of 2000 mL/day of clear fluids 2. A client is brought to the emergency room with a 30 percent burn over her lower extremities. Which of the following interventions should the nurse perform first? a. Clean and dress the wound b. Remove the clients clothing c. Administer a tetanus booster d. Initiate a peripheral IV 3. A nurse is caring for a client admitted to the nursing unit from the PACU following a craniotomy. The initial nursing assessment should focus on a. Intracranial pressure b. Pupillary reflexes c. Level of consciousness d. Airway patency 4. A nurse is caring for a client who has just returned from the surgical suite following a thoracotomy. Which of the following postoperative interventions should the nurse give highest priority to? a. Administer oxygen by mask via cannula at 6 L/min b. Monitor urinary output via foley catheter every 2hr c. Assess chest tube drainage hourly d. Maintain intravenous of D 5 ½ normal saline at 125 mL/hour 5. A nurse is caring for a client who has acute pancreatitis. After the client’s pain has been addressed, which of the following is next intervention to include in the plan of care? a. Monitor respiratory status every 8 hr b. Encourage a side-lying position with knees flexed c. Provide frequent oral hygiene d. Maintain NPO status 6. A nurse in the emergency department is caring for a client who has a myasthenia gravis and is in crisis. The nurse knows that which of the following factors can cause myasthenic crisis? a. Developing a respiratory infection b. Taking too much prescribed medication c. Not getting enough sleep d. Not exercising enough 7. A nurse is monitoring cardiac output on a client who has left-sided heart failure. The nurse should expect which of the following findings to compromise the readings? a. The client who has premature atrial contractions b. The client who has decreased oxygen saturations c. The client who has bilateral wheezes 21. A nurse is teaching the family of a client who is receiving treatment for a spinal cord injury with a halo fixation device. Which of the following statements by the nurse is appropriate? a. This device is use to treat injury to the lumbar spine b. The purpose of this device is to immobilize the cervical spine c. This device provides pain relief through compression of the spinal nerves d. The purpose of this device is to allow for neck movement during the healing process. 22. A nurse is planning preventative care for a client who had a traumatic brain injury and is emerging restlessly from a coma. Which of the following is an appropriate nursing action? a. Apply restraints b. Administer opioids c. Darken the room d. Reduce stimuli 23. A nurse is teaching a client who has rheumatoid arthritis about self-care techniques. Which of the following strategies should she include to illustrate the concept of joint protection? a. Press water from a sponge rather than wringing it b. Lift objects instead of sliding or pushing them c. Finish weekly household tasks within 1 or 2 days d. Engage in repetitive tasks that keep the joints mobile. 24. A nurse is assessing a client who has right ventricular failure. Which of the following findings should the nurse expect? a. A dry, hacking cough b. Hepatomegaly c. Dizziness d. Crackles 25. A nurse is caring for an adolescent client in the emergency department who sustained a head injury. The nurse notes the client’s IV fluids are infusing at 125 mL/hr. Which of the following is an appropriate action by the nurse? a. Slow the rate to 20 mL/hr b. Continue the rate at 125 mL/hr c. Slow the rate to 50 mL/hr d. Increase the rate to 250 mL/hr 26. A nurse assessing a client determines that he is in the compensatory stage of shock. Which of the following findings support this conclusion? a. Confusion b. Lethargy c. Unconsciousness d. Petechiae 27. A nurse is preparing a client for a barium swallow to evaluate dysphagia. Which statement indicates to the nurse that the client understands the instructions? a. I should take all my oral medications before I come in the morning b. I will drink plenty of fluids the morning of the tests c. I will remove my metal jewelry before coming in for the test d. I will bring a snack because ill be here all day 28. A nurse is caring for a client who has bleeding esophageal varices treat with a sengstaken-blakemore tube. Which of the following nursing actions is appropriate for the nurse to perform? a. Deflate the balloons for 5 mins ever 2 hrs to prevent tissue necrosis b. Maintain constant observation wile the balloons are inflated c. Suction the tube every 2 hrs and as needed to maintain patency d. Keep the head of the bed flat at all times to prevent development of shock 29. A nurse on a medical unit is caring for a client who has infective endocarditis. The nurse should observe this client for manifestations of a common complication of this disorder by monitoring for a. A heart murmur b. Dyspnea c. Fever d. Petechiae 30. A client who is taking medications to treat hypertension has potassium level of 6.8 mEq/L. Besides notifying the provider, which of the following actions should the nurse take? a. Suggest that the client use a salt substitute b. Obtain a 12-lead ECG c. Advice the client to add citrus juices and bananas to her diet d. Obtain a blood sample for a serum sodium level 31. The nurse is caring for a client who is receiving treatment following a motor vehicle crash. Which of the following is appropriate for determining the client’s alertness? a. Check clients eye opening in response to verbal stimuli b. Check pupillary response to light c. Check clients motor response to nail bed pressure d. Check clients response to questions about place and time 32. A nurse is suctioning the endotracheal tube of a client who is on a ventilator. The client’s heart rate increases from 86/min to 110/min and becomes irregular. The nurse should know that the client requires a. a cardiology consult b. less frequent suctioning c. an antidysrhythmic medication d. pre-oxygenation prior to suctioning 33. A nurse is assessing the effectiveness of elastic bandage on the stump of a client who had a right below-the-knee amputation. Which of the following findings should alert the nurse to a possible complication? a. Pitting edema around the stump dressing b. Looseness of the stump dressing c. The dressing forming a cone shape over the stump d. Figure-eight wrapping around the stump 34. A nurse caring for a client who reports pleuritic pain on the right side. The nurse notices that the client has dyspnea, decreased movement of the chest wall, and absent breath sounds on the right ride. The nurse should suspect that the client has which of the following? a. Pleural effusion b. Pulmonary embolism c. Pulmonary infection d. Empyema 35. A nurse suspects a client with myasthenia gravis is experiencing myasthenic crisis. Which of the following interventions is appropriate? a. Prepare the client for mechanical ventilation b. Administer an anticholinesterase medication c. Instruct the client to perform the pursed lip breathing d. Schedule the client for immediate dialysis 36. A client arrives at the emergency department following an explosion at a chemical plant. He has deep partial and full thickness chemical burns over more than 25% of his body surface area. What is the nurse’s priority intervention for this client? a. Initiate fluid resuscitation b. Medicate for pain c. Administer antibiotics d. Maintain a patent airway 37. In preparation for the discharge of a client with PAD, the nurse should include which of the following instructions? a. Apply a heating pad on a low setting to help relieve leg pain b. Adjust the thermostat so that the environment is warm c. Wear antiembolic stocking during the day d. Rest with legs above the heart level 38. A client tells the nurse at the clinic that she thinks she might be developing rheumatoid arthritis because she has some stiffness in her joints. Which other early manifestation of RA should the nurse expect to find when she assesses the client? a. Muscle atrophy b. Fatigue c. Temporomandibular joint pain d. Decrease ROM 39. A nurse is creating plan of care for a client who has advanced cirrhosis. Which of the following manifestation should the nurse expect to find? a. Petechiae b. Vitamin C deficiency c. Osteoarthritis d. Peripheral ulcers 40. A nurse on a critical care unit is caring for a client who has shallow and rapid respirations, paradoxical pulse, CVP 4 cm H2O, BP 90/50 mmHg, skin cold and pale, and urinary output 55mL over the last 2 hr. From these findings the nurse concludes that he may be developing which of the following? a. Attach the leads a 12 lead ECG b. Obtain the blood sample c. Initiate oxygen therapy d. Insert the IV catheter 53. A nurse is preparing to transfuse a client with a unit of RBC. During the first 15 min, which of the following infusion rates should the nurse start the RBC at? a. 10 mL/min b. 5 mL/min c. 40 mL/min d. 20 mL/min 54. A nurse is planning care for a client who has acute glomerulonephritis related to a streptococcal infection. Which of the following interventions is appropriate to include in the plan of care? a. Administer prescribed antibiotics b. Encourage increased fluid intake c. Obtain weekly weight d. Encourage frequent ambulation 55. A nurse is caring for a client following a renal biopsy. Which of the following interventions are appropriate? (select all that apply) a. Monitor for hematuria b. Check for flank pain c. Monitor for extravasation of tissue surrounding the biopsy site d. Encourage ambulation e. Administer aspirin PRN for pain 56. A nurse is responding to a client who has esophageal varices from portal hypertension. The client has IV fluids infusing and has a blood pressure of 68/48 after vomiting up 500 ml of blood. Which of the following actions may the nurse plan to do first? a. Position in reverse trendelenburg b. Increase IV fluid rate c. Start a doputamine (Dobutrex) drip d. Infuse a unit of packed RBC 57. A nurse is caring for a client admitted to the hospital with a diagnosis of myasthenia gravis. The nurse should observe the client for a. Confusion and disorientation b. Respiratory difficulty c. Manifestations of increased intracranial pressure d. Increased urine output 58. A client visits his provider’s office stating that he does not feel like himself. Laboratory testing indicates a low potassium level. Which of the following physiological responses should the nurse expect related to the client’s hypokalemia? a. Cardiac dysrhythmias b. Hypoglycemia c. Hyperreflexia d. Increased appetite 59. A nurse is caring for a client who came to the ED reporting chest pain. The provider suspects a myocardial infarction. While waiting for the laboratory to report the client’s troponin levels, the client asks what this blood test will show. The nurse should explain that troponin is a. An enzyme the indicates damage to brain, heart, and skeletal muscle tissues b. A protein whose levels reflect the risk for CAD c. A heart muscle protein that appears in the bloodstream when there is damage to the heart d. A protein that helps transport oxygen throughout the body 60. A client comes to the ED reporting chest pain that is sharp, knife-like, and localized to an ear he points to with one finger. The nurse should document this chest pain as which of the following? a. Angina pectoris b. Cardiogenic pain c. Myocardial infarction d. Pleuritic pain 61. A nurse is preparing to administer an osmotic diuretic IV to a client with increased intracranial pressure. Which of the following statements indicates the nurse understands the rationale for using this solution? a. Reduce edema of the brain b. Provide fluid hydration c. Increase cell size in the brain d. Expand extracellular fluid volume 62. A nurse in a clinic is caring for a client who has a prescription for digoxin (lanoxin). Which of the following statements by the client indicates the client is experiencing digoxin toxicity? a. I am gaining weight b. I am constipated c. My vision seems yellow d. My tongue is red and beefy 63. A nurse is caring for a client diagnosed with glomerulonephritis who has recurrent hypertension and edema. Analyzing the client’s lab results in relation to his disease process, the nurse would expect to find a increase in which of the following values? a. Creatinine clearance b. RBC c. BUN d. Specific gravity 64. A nurse is assessing an adult who has meningococcal meningitis. Which of the following is an appropriate finding by the nurse? a. Severe headache b. Bradycardia c. Increased muscle tone d. Oriented to time, person, and place 65. A Triage nurse in an ED is caring for a client who has a gunshot would to the right side of her chest. The nurse notes a think dressing on the chest and a sucking noise coming from the wound. The client has a blood pressure of 100/60 mmHg, a weak pulse rate of 118/min, and a respiratory rate of 40/min. Which of the following actions should the nurse take initially? a. Raise the foot of the bed to a 90 degree angle b. Remove the dressing to inspect the wound c. Prepare to insert a central line d. Administer oxygen via nasal cannula 66. A nurse is reading a client’s ECG tracing. Which component of the ECG should the nurse examine to determine the time it takes for ventricular depolarization and repolarization? a. PR interval b. QT interval c. ST segment d. QRS complex 67. A nurse is caring for a client who was diagnosed with systemic scleroderma 5 years ago. The nurse plans to assess the client to document the disease’s progression. In addition to skin changes, which of the following findings should the nurse expect? a. Periorbital edema b. Excessive salivation c. Finger contractures d. Thinning of the skin 68. A nurse is shipping and finds a woman who has collapsed with right-sided weakness and slurred speech. Which of the following does the nurse appropriate? a. Obtain the number of client’s provider b. Find a location for the client to sit c. Call emergency management services d. Drive the client to the nearest emergency treatment 69. A nurse is caring for a client who has aphasia following a stroke. A family member asks the nurse how she should communicate with the client. Which of the following is an appropriate response by the nurse? a. Incorporate nonverbal cues in the conversation b. Ask multiple choice questions as part of the conversation c. Use a higher-pitched tone of voice when speaking d. Use simple child-like statements when speaking 70. A nurse is admitting a client who has bacterial meningitis. The nurse notes during the physical examination that the client cannot extend his leg when his hip is flexed so that his thigh rests on his abdomen. The nurse should document this as which of the following? a. Brudzinski’s sign b. Chvostek’s sign c. Goodell’s sign d. Kernig’s sign a. Have the client empty his bladder b. Put up the side rails on the client’s bed c. Ask the client to take a few sips of water d. Place the client in low fowlers position 84. A nurse is caring for an adult client who is in compensatory stage of shock. Which of the following is an expected finding? a. Mottled skin b. BP 115/68 c. Heart rate 160/min d. Metabolic acidosis 85. A nurse is caring for a client at risk for disseminated intravascular coagulopathy (DIC). Which of the following lab values should the nurse report to the provider? a. Hemoglobin 15 b. Prothrombin time (PT) 12 sec c. Partial Thrombroplastin time (PTT) 2 d. Fibrinogen 85 86. A nurse is planning to prioritize client care after receiving report and rounded on assigned patients. Which of the following client’s is a high priority for the nurse to see first? a. A client who is ambulatory and going for an x-ray at 10 b. A client who is to be discharged at 11 c. A client who received pain medication 30 mins ago d. A client who is short of breath 87. A nurse is caring for a client with a Swan-Ganz catheter. The nurse will use this catheter to monitor which of the following? a. Intracranial pressure b. Spinal cord perfusion c. Renal function d. Hemodynamic status 88. An ED nurse is caring for a client who has an epidural hematoma following a motor vehicle crash. Which of the following is an expected finding? a. Narrowing pulse pressure b. Drainage of clear fluid from the ears c. Alternating periods of alertness and unconsciousness d. Extensive bruising in the mastoid area 89. A nurse is caring for a client diagnosed with chronic glomerulonephritis. The nurse would expect to find a decrease in which of the following serum laboratory values? a. Potassium b. Phosphate c. Creatinine d. RBC 90. A nurse is caring for a client who has nephrotic syndrome and is receiving high dose corticosteroid therapy. To detect an electrolyte imbalance caused by the corticosteroid use the nurse should monitor the client for which of the following? a. Itching b. Muscle weakness c. Poor skin turgor d. Hunger 91. A nurse in the ED is admitting a client with extensive burn injury who has no known medical problems. Which of the following is an expected laboratory finding in this client? a. Metabolic alkalosis b. Hypervolemia c. Hyperkalemia d. Low hemoglobin 92. A nurse in the ED is caring for a client who has diabetic ketoacidosis (DKA) with a serum blood glucose of 925 which of the following does the nurse anticipates administering? a. Glucocorticoid medications b. 5% dextrose in 0.45% sodium chloride solution IV c. Oral hypoglycemic medications d. A bolus of 0.9% sodium chloride solution with regular insulin IV 93. A nurse is preforming discharge teaching for a client who has systemic lupus erythematosus (SLE). Which of the following instructions should the nurse include? a. Avoid using moisturizing lotions on the skin b. Wash the hair with mild protein shampoo c. Apply powder liberally to sensitive skin areas d. Use a sun-blocking agent with a sun protection factor of at least 15. 94. A nurse in the ED is caring for a client who reports chest pressure, indigestion, fatigue, and occasional SOB. Which of the following laboratory tests will provide the most specific indication whether or not the client has had a myocardial infarction? a. Troponin b. Myoglobin c. Creatinine kinase d. Aspartate aminotransferase (AST) 95. A nurse is caring for a client who is postoperative following vascular surgery. Which of the following signs should indicate to the nurse that the client has developed a thrombus? a. Positive Kernig’s sign b. Positive Homan’s sign c. Dull, aching calf pain d. Soft, pliable calf muschle 96. An older adult client with a history of myocardial infarction comes to the ED reporting bilateral calf pain. He states that it started 2 weeks ago when he began to more advance stretching and exercise regimen. The client also states that he has been having indigestion for the past 24 hr. Which of the following is the nurse’s priority action? a. Further questioning the client about his indigestion b. Obtaining an ECG for the client c. Applying warm moist wraps to the client’s lower legs d. Checking the client’s calves for redness and warmth 97. A client who has had rheumatoid arthritis for 3 years reports increasing pain and stiffness in her hands, especially in the morning. On physical examination the nurse in the clinic should expect which of the following findings? a. Anorexia b. Knuckle deformity c. Low grade fever d. Reddened joints 98. A nurse is caring for a client who has acute renal failure. Which of the following arterial blood gas values would the nurse expect this client to have? a. pH 7.49, HCO3 24, PaCO2 30 b. pH 7.49, HCO3 28, PaCO2 46 c. pH 7.26, HCO3 24, PaCO2 46 d. pH 7.26, HCO3 14, PaCO2 30 99. A nurse is caring for a client who has sustained life-threatening injuries due to a motor vehicle accident. Identify the sequence the nurse should take in treating the client. a. First check breathing, second use head tilt chin life if airway is obstructed, and third control bleeding, and last treat shock. 100. A nurse in the emergency department is caring for a victim of a suspected bioterrorism event involving exposure to cutaneous anthrax. Which of the following is an expected finding? a. Immediate onset of respiratory distress b. Flu-like symptoms 48hr after exposure c. Itching of the skin progressing to ulceration over 1 to 7 days d. Immediate onset of vesicular lesions of the skin 101. While admitting a client for a cardiac catheterization the nurse asks the client about allergies. The client states, “ I always get a rash when I eat shellfish.” Which of the following is the priority nursing intervention? a. Notify the provider of the client’s allergy b. Attach a wrist band indicating the client’s allergy c. Ask the client if any other foods cause such a reaction d. Notify the dietary department of the client’s allergy 102. A nurse is talking with a client who is about to starting using nitroglycerin to treat angina pectoris. The client asks the nurse how long he has to take the medication before his condition is cured. The nurse should first a. Ask the client what he knows about his diagnosis b. Make sure the client knows how to take his mediation c. Provide the client with written information about angina pectoris d. Explain that the medication may help control the client’s symptoms b. The medication should be discontinued 3 months prior to a planned pregnancy c. Dosage of the medication will be reduced during pregnancy d. The client can breast feed when taking this medication 116. A nurse in the ED is caring for a client who was injured in a motor- vehicle crash. The client reports dyspnea and severe pain. The nurse notes that his chest move inward during inspiration and bulges out during expiration. The nurse should suspect which of the following? a. Atelectasis b. Flail chest c. Hemothorax d. Pneumothorax 117. A nurse is caring for a client following a total laryngectomy. Which of the following should the nurse be aware of as the priority observation in the clients care? a. Patency of intravenous line b. Level of pain c. Integrity of the dressing d. Need for suctioning 118. A nurse is assessing a client who has an acute myocardial infarction. Which of the following clinical manifestations should the nurse expect to find? (Select all that apply) a. Orthopnea b. Headache c. Nausea d. Tachycardia e. Diaphoresis 119. A nurse is admitting a client who has acute heart failure following a MI and is reviewing the provider’s orders. Which of the following prescriptions by the provider requires clarification? a. Morphine sulfate 2 mg IV bolus Q 2 hr PRN pain b. Laboratory testing of serum potassium upon admission c. 0.9% normal saline IV at 50 mL/hr continuous d. Bumetanide 1 mg IV bolus Q 12 hr 120. A nurse creates a plan of care for a client who has a traumatic head injury to determine motor function response. Which of the following client responses to painful stimulus is within normal limits? a. Pushes the painful stimulus away b. Extends the body part toward the stimuli c. Shows no reaction to painful stimuli d. Flexes upper and extends the lower extremities 121. A nurse is planning care for a client who has quadriplegia. Which of the following actions are most essential for prevention of pulmonary emboli? (Select all that apply) a. Assess legs for redness b. Apply elastic compression stockings c. Perform passive ROM exercises d. Monitor INR results e. Massage calves every shift 122. A client who has had a significant MI receives a referral to the cardiac rehabilitation unit. During his first visit to the unit, he tells the nurse that he doesn’t understand why he needs to be there because there is nothing more to do as the damage is done. Which of the following is an appropriate nursing response? a. Cardiac rehabilitation cannot undo the damage to your heart but it can help you get back to your previous level of activity safely b. It’s not unusual to feel that way at first, but once you learn the routine, you’ll be fine c. You are probably right and I agree with you, but I still think you should go d. Your doctor is the expert here, and I’m sure he would only recommend what is best for you