NR 226 Exam 2

NR 226 Exam 2

NR 226 Exam 2

Name

Chamberlain University

NR-226: Fundamentals – Patient Care

Prof. Name

Date

NR 226: Exam 2 Review Questions

  1. A nurse suspects a fluid and electrolyte imbalance in an older adult. Which assessment best indicates fluid and electrolyte balance?

    • a. Intake and output results
    • b. Serum laboratory values
    • c. Condition of the skin
    • d. Presence of tenting
  2. A nurse is caring for a patient with an intestinal stoma. Which intervention is most important?

    • a. Cleansing the stoma with cool water
    • b. Spraying an air-freshening deodorant in the room
    • c. Selecting a bag with an appropriate-size stomal opening
    • d. Wearing sterile nonlatex gloves when caring for the stoma
  3. A nurse is caring for a patient who had an abdominal hysterectomy. Which intervention best prevents postoperative thrombophlebitis (DVT)?

    • a. Utilization of compression stockings at night
    • b. Deep breathing and coughing daily
    • c. Leg exercises 10 times per hour when awake
    • d. Elevation of the legs on 2 pillows
  4. The nurse monitors a client with a nasogastric tube attached to low suction for manifestations of which disorder?

    • a. Metabolic acidosis
    • b. Metabolic alkalosis
    • c. Respiratory acidosis
    • d. Respiratory alkalosis
  5. A client with broken ribs is likely to experience what type of acid-base imbalance?

    • a. Respiratory acidosis from inadequate ventilation
    • b. Respiratory alkalosis from anxiety and hyperventilation
    • c. Metabolic acidosis from calcium loss due to broken bones
    • d. Metabolic alkalosis from taking analgesics containing base products
  6. A patient with diarrhea needs to replace potassium. Which nutrient selections indicate additional teaching on potassium-rich foods is needed? (Select all that apply.)

    • a. Beef bouillon
    • b. Orange juice
    • c. Poached egg
    • d. Warm tea
    • e. Avocado
  7. A 750-mL tap-water enema is ordered for a patient. Which approach best promotes acceptance of the volume?

    • a. Administer the fluid slowly, and have the patient take shallow breaths
    • b. Place the patient in the left lateral position, and slowly administer the fluid
    • c. Have the patient take shallow breaths, and keep the fluid at body temperature
    • d. Keep the fluid at body temperature, and place the patient in the left lateral position
  8. Which information indicates a patient at highest risk for developing diarrhea?

    • a. Is physically active
    • b. Drinks a lot of fluid
    • c. Eats whole-grain bread
    • d. Is experiencing emotional problems
  9. Sequential compression devices (SCD) are ordered for a postoperative patient. Which information should the nurse provide? (Select all that apply.)

    • a. Keeps the lower extremities warm
    • b. Helps prevent deep vein thrombosis
    • c. Accelerates the rate of wound healing
    • d. Promotes circulation of blood back to the heart
    • e. Eliminates the need for leg and foot exercises after surgery
  10. A patient in the post anesthesia care unit (PACU) has vital signs: BP 150/90 mm Hg, pulse 88 (bounding), respirations 24 with crackles. What is the patient likely experiencing?

    • a. Hypoglycemia
    • b. Hyponatremia
    • c. Hyperkalemia
    • d. Hypervolemia
  11. A patient reports no bowel movement in 10 days. Which questions help assess for fecal impaction? (Select all that apply.)

    • a. “How long has it been since you had a formed stool?”
    • b. “Have you had small amounts of liquid stool?”
    • c. “Do you notice a bad odor to your breath?”
    • d. “Have you been eating food with fiber?”
    • e. “Are you having any vomiting?”
  12. A postoperative client becomes restless. What should the nurse do first?

    • a. Notify the physician
    • b. Medicate the patient for pain
    • c. Check the client’s vital signs
    • d. Talk to the client in a calm voice
  13. A client scheduled for surgery expresses uncertainty about proceeding. What is the nurse’s best response?

    • a. “It is your decision.”
    • b. “Do not worry. Everything will be fine.”
    • c. “Why do you not want to have this surgery?”
    • d. “Tell me what concerns you have about the surgery.”
  14. When explaining at-home fecal occult blood testing, which instructions should the nurse include?

    • a. Eating more protein is optimal prior to testing
    • b. Continue all scheduled medications, including aspirin, before the test
    • c. A red color change indicates a positive result
    • d. The specimen must not be contaminated with urine
  15. A nurse assesses a client who has had diarrhea for 4 days. Which findings are expected? (Select all that apply.)

    • a. Bradycardia
    • b. Hypotension
    • c. Elevated temperature
    • d. Poor skin turgor
    • e. Peripheral edema
  16. A client receiving IV therapy reports arm pain, chills, and general malaise, with warmth, edema, and redness near the IV site. What is the nurse’s first action?

    • a. Obtain a specimen for culture
    • b. Apply a warm compress
    • c. Administer analgesics
    • d. Discontinue the infusion
  17. During an admission assessment, which findings would the nurse not expect in a client with hypovolemia due to vomiting and diarrhea? (Select all that apply.)

    • a. Flat neck veins
    • b. Thready pulse
    • c. Syncope
    • d. Dark urine
    • e. Postural hypotension
  18. A client’s potassium level is 5.2 mEq/L. What should the nurse anticipate after notifying the provider?

    • a. Starting an IV infusion of 0.9% sodium chloride
    • b. Consulting with a dietician to increase potassium intake
    • c. Initiating continuous cardiac monitoring
    • d. Preparing the patient for gastric lavage
  19. A nurse assesses a client with a calcium level of 10.8 mEq/L. Which findings are expected? (Select all that apply.)

    • a. Hyperreflexia
    • b. Muscle weakness
    • c. Positive Chvostek’s sign
    • d. Muscle cramps
    • e. Kidney stones

NR 226 Exam 2