NUR392-910 Fundamentals Final Summer - Adelphi University
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Free NUR392-910 Fundamentals Final Summer - Adelphi University Questions
A nurse monitors the patient's vital signs. The cardiac monitor displays a high blood pressure of 187/100 mmHg. Medical orders state to notify the health care provider for diastolic blood pressure greater than 90 mmHg. Which of the following actions should the nurse take initially?
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Review the most recent lab results for the patient's potassium level
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Assess the patient for other symptoms or problems, and then notify the health care provider
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Administer an antihypertensive medication from the stock supply, and then notify the health care provider
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Follow the clinical protocol for a stroke
Explanation
Correct Answer Is:
B
Why the other options are incorrect:
A. Reviewing potassium levels is not the priority action for an elevated blood pressure reading and does not directly address the immediate need to assess the patient's current clinical status.
C. Administering medication without a provider's order is outside the nurse's scope of independent practice and is unsafe; medications should not be given from stock without a specific order.
D. There is no indication of stroke symptoms in this scenario; following a stroke protocol would be inappropriate without supporting clinical findings.
A patient develops dyspnea and feels tired after completing her morning care. Which of the following should the nurse include in the patient's plan of care for the next day?
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Perform all of the patient's care as quickly as possible
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Skip all hygiene care in the morning
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Ask a family member to come in to give the patient a bath
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Plan for several rest periods during morning care
Explanation
Correct Answer: (D) Plan for several rest periods during morning care For a patient experiencing dyspnea and fatigue with activity, the appropriate nursing intervention is to pace care with scheduled rest periods, allowing the patient to conserve energy and reduce cardiopulmonary strain while still receiving necessary care. This approach respects the patient's need for activity tolerance management without compromising hygiene needs.
Why the other options are incorrect:
A. Rushing through care would increase physical exertion and could worsen dyspnea and fatigue rather than helping the patient conserve energy.
B. Skipping hygiene care entirely neglects the patient's basic care needs and is not an appropriate solution to activity intolerance.
C. Delegating care to a family member does not address the underlying need for energy conservation techniques and is not a nursing intervention that resolves the clinical problem.
The nurse is ambulating a client who had a knee replacement 2 days ago. The client suddenly becomes short of breath and has chest pain. The nurse suspects the client may be experiencing which of the following complications?
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Disconnect the chest tube from the drainage system when ambulating the client
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Clean the filter regularly to avoid a bad taste
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Assess the water suction control chamber for gentle bubbling
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Assess the collection chamber for consistent drainage
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Assess the water seal chamber for "tidaling"
Explanation
Correct Answer: (C, D, E) Assess the water suction control chamber for gentle bubbling; Assess the collection chamber for consistent drainage; Assess the water seal chamber for "tidaling" Proper monitoring of a closed chest drainage system includes observing the suction control chamber for gentle, continuous bubbling (indicating appropriate suction), tracking the amount and character of drainage in the collection chamber, and checking the water seal chamber for tidaling (fluctuation with respiration), which confirms system patency and proper lung re-expansion.
Why the other options are incorrect:
A. The chest tube should never be disconnected from the drainage system, including during ambulation, as this breaks the closed system and risks pneumothorax; the system should be kept below chest level and moved with the client.
B. This option does not reflect an actual component or maintenance task of a closed chest drainage system; there is no "filter" requiring cleaning for taste in this context.
A client tells the nurse that he takes laxatives every day but is still constipated. Which of the following responses by the nurse is most appropriate?
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A laxative that works by a different method should be used
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Habitual laxative use is the common cause of chronic constipation
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Chronic constipation is nothing to be concerned about
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If laxatives are not effective, the client should begin to use enemas
Explanation
The nurse is caring for a client with an ileostomy. What type of drainage from the ileostomy should the nurse expect?
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Soft formed feces
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Liquid feces
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Flatus but no feces
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Hard formed feces
Explanation
An ileostomy diverts stool from the ileum (small intestine), before it reaches the colon, where water is normally reabsorbed. As a result, ileostomy output is typically liquid to semi-liquid in consistency, since the stool has not passed through the colon for water absorption.
Why Other Options are Incorrect:
A. Soft formed feces are more characteristic of output from a colostomy located further along the colon (such as a descending or sigmoid colostomy), where more water reabsorption has occurred.
C. Flatus but no feces is not an accurate expectation for an ileostomy, as continuous liquid stool output is a normal and expected characteristic.
D. Hard formed feces would be expected from a normal, intact colon and rectum, not from an ileostomy, since the colon's water-reabsorption function is bypassed.
The nurse is caring for a client with an order for a non-rebreather mask. Which of the following interventions are appropriate for the nurse to use? Select all that apply.
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Monitor the client's oxygen saturation level
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Keep the reservoir bag on the mask 50% full
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Check that the rubber flaps on the mask are functioning correctly
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Keep the reservoir bag full with only slight collapse during inspiration
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Have the client remove the mask for 15 minutes every hour
Explanation
Correct Answer: (D) Increased pulse and blood pressure Acute pain activates the sympathetic nervous system, triggering a stress response that typically results in increased heart rate, increased blood pressure, and increased respiratory rate as the body responds to the perceived threat or tissue injury.
Why the other options are incorrect:
A. Acute pain characteristically produces measurable physiological changes due to sympathetic activation; vital signs are not expected to remain unchanged.
B. Acute pain triggers a sympathetic response that increases, not decreases, pulse and respirations.
C. Increased temperature is not a typical or expected physiological response to acute pain; temperature changes are more associated with infection or inflammatory processes.
The nurse is preparing a patient for a surgical procedure on the right great toe. Which of the following actions would be most important to include in this patient's preparation?
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Ascertain that the surgical site has been correctly marked
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Ascertain the patient has home support after the procedure
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Place the patient in a clean surgical gown
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Ascertain where the family will be located during the procedure
Explanation
Correct Answer Is:
A
Why the other options are incorrect:
B. While arranging home support is a valid discharge planning consideration, it is not as immediately critical to patient safety as verifying the correct surgical site prior to the procedure.
C. Placing the patient in a clean surgical gown is a routine preparatory task but does not carry the same safety priority as preventing a wrong-site surgical error.
D. Knowing the family's location is a matter of communication and comfort, not a critical safety step in preventing surgical error.
Which type of precautions is needed for a client with HIV and no other infections?
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Droplet
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Airborne
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Protective
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Standard/Universal
Explanation
HIV is transmitted through direct contact with blood and certain body fluids, which is adequately addressed through Standard/Universal Precautions. These precautions include practices such as hand hygiene and use of personal protective equipment when contact with blood or body fluids is anticipated, and they are sufficient for a client with HIV who has no other co-existing infections requiring additional precautions.
Why Other Options are Incorrect:
A. Droplet precautions are used for infections spread through respiratory droplets (e.g., influenza, pertussis), which is not the transmission route for HIV.
B. Airborne precautions are used for infections spread through small airborne particles (e.g., tuberculosis, measles), which does not apply to HIV transmission.
C. Protective (reverse) precautions are used to protect immunocompromised clients from external pathogens, not to prevent transmission of HIV from the client to others.
A nurse has performed a bladder scan on a client to measure postvoid residual (PVR) amount. The nurse obtains 20 mL of urine. What should the nurse do next?
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Report this abnormal finding to the physician
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Perform another catheterization to verify the amount
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Palpate the abdomen for a distended bladder
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Document this normal finding for postvoid residual
Explanation
Correct Answer Is:
D
Why the other options are incorrect:
A. A PVR of 20 mL is a normal finding, not an abnormal one, so there is no indication to report it to the physician.
B. Catheterization to verify the amount is an invasive step that is not warranted when a bladder scan has already produced a normal, expected result.
C. Palpating the abdomen for bladder distention would not be necessary since the scan already confirms the bladder is adequately emptied at a normal volume.
Parameter the nurse should monitor for this condition A. Urine output B. Musculoskeletal status C. Pain scale out of 10
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Serum electrolyte levels every 4 hours as ordered
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Blood pressure
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Ability to perform ADLs
Explanation
Correct Answer: (1) C — Hypocalcemia — Mrs. Black's recent parathyroidectomy places her at high risk for hypocalcemia, since the parathyroid glands regulate calcium levels. Her presentation—perioral numbness and tingling, fingertip paresthesia, positive Chvostek's sign (facial twitching), positive Trousseau's sign (carpal pedal spasm), and muscle tightening/cramping in the extremities—is classic for hypocalcemia following parathyroid removal. (2) A — Initiate IV calcium supplementation — IV calcium replacement is the priority treatment to correct symptomatic hypocalcemia and prevent progression to more severe complications such as tetany, laryngospasm, or seizures. (3) B — Initiate seizure and fall precautions — Severe hypocalcemia can progress to neuromuscular irritability, tetany, and seizures, so the nurse must implement safety precautions to protect the client from injury. (4) B — Musculoskeletal status — Ongoing monitoring of muscle cramping, spasms, and neuromuscular irritability (Chvostek's/Trousseau's signs) allows the nurse to track the progression or resolution of hypocalcemia symptoms. (5) A — Serum electrolyte levels every 4 hours as ordered — Frequent monitoring of serum calcium and other electrolytes is essential to evaluate the effectiveness of calcium replacement therapy and detect any further imbalance.
Why the other options are incorrect:
Hyperkalemia, hyponatremia, and hypermagnesemia do not correlate with the classic signs presented (Chvostek's, Trousseau's, perioral numbness); these are hallmark findings specifically associated with hypocalcemia.
Allowing the client to ambulate to the bathroom is unsafe given her risk for tetany/seizure, and starting a fluid-restricted diet does not address the underlying calcium deficiency.
Administering Dextrose 50% IV with insulin is a treatment for hyperkalemia, not hypocalcemia, and initiating 3% NS IV is used for severe hyponatremia, neither of which fits this client's presentation.
Urine output and pain scale are not the most specific or relevant parameters for tracking hypocalcemia progression compared to musculoskeletal status; ability to perform ADLs and blood pressure are not the priority monitoring parameters for this acute electrolyte imbalance compared to serum electrolyte levels.
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