Question 1
A
nursing student wants to know why clients with chronic obstructive pulmonary
disease tend to be polycythemic. What response by the nurse instructor is best?
Question 2
A
nurse assesses a client who had a myocardial infarction and is hypotensive.
Which additional assessment finding should the nurse expect?
Question 3
A
nurse assesses a client in an outpatient clinic. Which statement alerts the
nurse to the possibility of left-sided heart failure?
Question 4
A
nurse assesses clients on a cardiac unit. Which client should the nurse
identify as being at greatest risk for the development of left-sided heart
failure?
Question 5
A
client is receiving rivaroxaban (Xarelto) and asks the nurse to explain how it
works. What response by the nurse is best?
Question 6
A
client undergoing hemodynamic monitoring after a myocardial infarction has a
right atrial pressure of 0.5 mm Hg. What action by the nurse is most
appropriate?
Question 7
A
nurse assesses a client with atrial fibrillation. Which manifestation should
alert the nurse to the possibility of a serious complication from this
condition?
Question 8
A
client has been diagnosed with hypertension but does not take the antihypertensive
medications because of a lack of symptoms. What response by the nurse is best?
Question 9
A
client received tissue plasminogen activator (t-PA) after a myocardial
infarction and now is on an intravenous infusion of heparin. The client’s
spouse asks why the client needs this medication. What response by the nurse is
best?
Question 10
The
nurse is reviewing the lipid panel of a male client who has atherosclerosis.
Which finding is most concerning?
Question 11
A
hospitalized client has a platelet count of 58,000/mm3. What action by the
nurse is best?
Question 12
A
client is in the hospital after suffering a myocardial infarction and has
bathroom privileges. The nurse assists the client to the bathroom and notes the
client’s O2 saturation to be 95%, pulse 88 beats/min, and respiratory rate 16
breaths/min after returning to bed. What action by the nurse is best?
Question 13
A
nurse is working with a client who takes atorvastatin (Lipitor). The client’s
recent laboratory results include a blood urea nitrogen (BUN) of 33 mg/dL and
creatinine of 2.8 mg/dL. What action by the nurse is best?
Question 14
While
assessing a client on a cardiac unit, a nurse identifies the presence of an S3
gallop. Which action should the nurse take next?
Question 15
The
nurse is evaluating a 3-day diet history with a client who has an elevated
lipid panel. What meal selection indicates the client is managing this
condition well with diet?
Question 16
A
client is in shock and the nurse prepares to administer insulin for a blood
glucose reading of 208 mg/dL. The spouse asks why the client needs insulin as
the client is not a diabetic. What response by the nurse is best?
Question 17
The
nurse gets the hand-off report on four clients. Which client should the nurse
assess first?
Question 18
A
nurse cares for a client with right-sided heart failure. The client asks, “Why
do I need to weigh myself every day?” How should the nurse respond?
Question 19
A
nurse cares for a client who has a heart rate averaging 56 beats/min with no
adverse symptoms. Which activity modification should the nurse suggest to avoid
further slowing of the heart rate?
Question 20
A
nurse is caring for a client after surgery. The client’s respiratory rate has
increased from 12 to 18 breaths/min and the pulse rate increased from 86 to 98
beats/min since they were last assessed 4 hours ago. What action by the nurse
is best?
Question 21
An
emergency room nurse obtains the health history of a client. Which statement by
the client should alert the nurse to the occurrence of heart failure?
Question 22
The
health care provider tells the nurse that a client is to be started on a
platelet inhibitor. About what drug does the nurse plan to teach the client?
Question 23
A
nurse assesses a client’s electrocardiograph tracing and observes that not all
QRS complexes are preceded by a P wave. How should the nurse interpret this
observation?
Question 24
A
nurse caring for a client with sickle cell disease (SCD) reviews the client’s
laboratory work. Which finding should the nurse report to the provider?
Question 25
A
nurse assesses clients on a medical-surgical unit. Which client should the
nurse identify as having the greatest risk for cardiovascular disease?
Question 26
A
student nurse is assessing the peripheral vascular system of an older adult.
What action by the student would cause the faculty member to intervene?
Question 27
A
nurse assesses a client after administering a prescribed beta blocker. Which
assessment should the nurse expect to find?
Question 28
A
nurse evaluates prescriptions for a client with chronic atrial fibrillation.
Which medication should the nurse expect to find on this client’s medication
administration record to prevent a common complication of this condition?
Question 29
A
nurse assesses an older adult client who has multiple chronic diseases. The
client’s heart rate is 48 beats/min. Which action should the nurse take first?
Question 30
A
client presents to the emergency department in sickle cell crisis. What
intervention by the nurse takes priority?
Question 31
A
nurse assesses a client admitted to the cardiac unit. Which statement by the
client alerts the nurse to the possibility of right-sided heart failure?
Question 32
A
nursing student is caring for a client who had a myocardial infarction. The
student is confused because the client states nothing is wrong and yet listens
attentively while the student provides education on lifestyle changes and
healthy menu choices. What response by the faculty member is best?
Question 33
A
client is receiving an infusion of tissue plasminogen activator (t-PA). The
nurse assesses the client to be disoriented to person, place, and time. What
action by the nurse is best?
Question 34
A
client in sickle cell crisis is dehydrated and in the emergency department. The
nurse plans to start an IV. Which fluid choice is best?
Question 35
A
student is caring for a client who suffered massive blood loss after trauma.
How does the student correlate the blood loss with the client’s mean arterial
pressure (MAP)?
Question 36
A
client has a serum ferritin level of 8 ng/mL and microcytic red blood cells.
What action by the nurse is best?
Question 37
A
nurse is assessing clients on a medical-surgical unit. Which client should the
nurse identify as being at greatest risk for atrial fibrillation?
Question 38
A
client hospitalized with sickle cell crisis frequently asks for opioid pain
medications, often shortly after receiving a dose. The nurses on the unit
believe the client is drug seeking. When the client requests pain medication,
what action by the nurse is best?
Question 39
A
nurse is caring for a client after surgery who is restless and apprehensive.
The unlicensed assistive personnel (UAP) reports the vital signs and the nurse
sees they are only slightly different from previous readings. What action does
the nurse delegate next to the UAP?
Question 40
A
nurse is assessing a dark-skinned client for pallor. What action is best?
