Physiological Integrity.

A nurse is preparing a patient for surgery. Which of the following should be included in the preoperative teaching?

Which of the following safety protocols is most important when caring for a patient who is receiving intravenous potassium?

The nurse is assessing a postoperative patient and notices the patient has a rapid, weak pulse, hypotension, and confusion. W hich condition is the nurse most concerned about?

A nurse is caring for a patient who is at risk for aspiration. Which of the following acti ons should the nurse take to promote patient safety during meals?

The nurse is caring for a patient receiving a blood transfusion. The patient develops chills, fever, and back pain during the infusion. What is the nurse’s priority action?

A nurse is providing preoperative teaching to a patient scheduled for surgery. Which statement made by the patient indicates an understanding of the teaching regarding postoperative activity restrictions?

A patient with dehydration has been prescribed intravenous fluids. The nurse notices that the patient’s skin turgor is poor, and the urine output is significantly reduced. Which laboratory value should the nurse monitor to assess the severity of the dehydration?

The nurse is caring for a patient who is experiencing acute pain. Which of the following interventions is most appropriate to provide relief?

A patient with chronic kidney disease is being monitored for fluid and electrolyte imbalances. Which of the following signs would the nurse expect to see in this patient?

A nurse is administering a blood transfusion. The patient begins to experience chills, fever, and itching. What is the nurse’s immediate action?

The nurse is caring for a patient with a central venous catheter (CVC) who develops a fever and swelling at the catheter insertion site. What should the nurse do first?

A patient with asthma is prescribed a bronchodilator. Which of the following is the most common side effect of this medication?

A nurse is caring for a pat ient who is receiving total parenteral nutrition (TPN). The nurse should monitor which of the following to evaluate the patient's tolerance to the TPN solution?

A nu rse is caring for a patient who is at risk for deep vein thrombosis (DVT). Which of the following interventions is most important in preventing the development of DVT?

A nurse is administering a diuretic to a patient with heart failure. Which of the following laboratory values should the nurse monitor close ly?

The nurse is preparing to administer a blood transfusion to a p atient. Which of the following actions is necessary to ensure patient safety?

A nurse is caring for a patient recovering from surgery. Which of the following interventions would be most effective to prevent atelectasis?

A nurse is caring for a patient receiving heparin therapy. The nurse should monitor for which of the following complications?

A patient with a history of myocardial infarction (MI) is prescribed a beta -blocker. Which of the following assessments should the nurse prioritize for this patient?

The nurse is c aring for a patient receiving an intravenous (IV) infusion of potassium chloride. The nurse observes that the IV site is red, swollen, and warm to the touch. What is the nurse’s first action?

A patient is receiving chemotherapy and complains of n ausea and vomiting. What is the nurse’s priority intervention?

A patient with chronic obstructive pulmonary disease (COPD) is being treated with a corticosteroid inhaler. Which of the following instructions should the nurse provide regarding the use of the inhaler?

A nurse is assessing a postoperative patient who is experiencing a temperature of 10 1°F (38.3°C). Which action should the nurse take first?

A patient is receiving IV potassium chloride for hypokalemia. The nurse notices that the infusion site is swollen and warm to the touch. What should the nurse do first?

A nurse is caring for a patient with a suspected myocardial infarction (MI). Which of the following is the priority i ntervention?

The nurse is preparing to teach a client with microcytic hypochromic anemia abou t the diet to follow after discharge. Which of the following foods should be included in the diet?

The nurse devises a teaching plan for the patient with aplastic anemia. Which of the following is the most important concept to teach for health maintenance?

A client was admitted with iron deficiency anemia and blood -streaked emesis. Which question is most appropriate for the nurse to ask in determining the extent of the client’s activity intoler ance?

A client with microcytic anemia is having trouble selecting food items from the hospital menu. Which food is best for the nurse to suggest for satisfying the client’s nutritional needs and personal preferences? 17

A client with macrocytic anemia has a burn on her foot and states that she had been watching television while lying on a heating pad. What is the nurse’s first response?

Which of the following nursing assessments is a late symptom of polycythemia vera?

Which of the following blood components is decreased in anemia?

A client with anemia may be tired due to a tissue deficiency of which of the following substances?

Which of the following diagnostic findings are most likely for a client with aplastic anemia?

A client with iron deficiency anemia is scheduled for discharge. Which instruction about prescribed ferrous gluconate therapy should the nurse include in the teaching plan?

A client has been admitted to the hospital with a diagnosis of suspected bacterial endocarditis. The complication the nurse will constantly observe for is:

When teaching a client with a cardiac problem, who is on a high -unsaturated fatty -acid diet, the nurse should stress the importance of increasing the intake of:

A 2-gram sodium diet is prescribed for a client with severe hypertension. The client does not like the diet, and the nurse hears the client request that the spouse “Bring in some good home -cooked food.” It would be most effective for the nurse to plan to:

What criteria should the nurse use to determine normal sinus rhythm for a client on a cardiac monitor? Check all that apply.

A depressed client is ready for discharge. The nurse feels comfortable that the client has a good understanding of the disease process when the client states:

The client is having a lumbar puncture performed. The nurse would plan to place the client in which position for the procedure?

A nurse midwife is performing an assessment of a pregnant client and is assessing the client for the presence of ballottement. Which of the following would the nurse implement to test for the presence of ballottement?

A homecare nurse visits a pregnant client who has a diagnosis of mild Preeclampsia and who is being monitored for pregnancy induced hypertension (PIH). Which assessment finding indicates a worsening of the Preeclampsia and the need to notify the physician?

A nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes. Which statement if made by the client indicates a need for further education?

A pregnant client is receiving magnesium sulfate for the management of preeclampsia. A nurse determines the client is experiencing toxicity from the medication if which of the following is noted on assessment?

Nutritional planning for a newly pregnant woman of average height and weighing 145 pounds should include:

Clients with gestational diabetes are usually managed by which of the following therapies?

The antagonist for magnesium sulfate should be readily available to any client receiving IV magnesium. Which of the following drugs is the antidote for magnesium toxicity?

To validate the suspicion that a married male client has sleep apnea the nurse first:

The nurse finds a client sleep walking down the unit hallway. An appropriate intervention the nurse implements is: