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Saunders Nclex -RN question 100 set of 1 of 5 Questions and Answers,100% CORRECT

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Saunders Nclex -RN question 100 set of 1 of 5 Questions and Answers 9. An older client has been lying in a supine position for the past 3 hours. The nurse who is repositioning this client would be ... most concerned with examining which bony prominences of the client? Select all that apply. Missed one answer: Heels, elbows, Ankles, sacrum and back of head What I learned from being wound care nurse is, lying on your back facing the ceiling the back of the head, heels, ankles, trochanter, sacrum, back and scapulae are all boney areas that are at greater risk for pressure sores to develop. The patient needs to be turned every two hours to elevated the weight on each side of the body. 35. The nurse is reviewing the arterial blood gas values of a client and notes that the pH is 7.31 (7.31), Paco2 is 50 mm Hg (50 mm Hg), and the bicarbonate (HCO3) level is 26 mEq/L (26 mmol/L). The nurse concludes that which acid-base disturbance is present in this client? Correct answer: Respiratory acidosis With respiratory acidosis, pH is decreased and Paco2 level increased. Respiratory alkalosis, pH elevated and Paco2 decrease. 56. The nurse in the labor room is performing an initial assessment on a newborn. The infant is exhibiting mild to moderate respiratory distress, audible bowel sounds in the chest, and a scaphoid abdomen. The infant is responding poorly to bag and mask ventilation. The nurse plans for which actions in the care of this infant? Correct answer: Position the infant flat on his or her right side. Worsening respiratory distress, bowel sounds in chest, lay baby flat on right side, flat or scaphoid abdomen are all signs and symptoms of a congenital diaphragmatic hernia. Need order for x- rays. Baby will need to be NPO, and need ventilation to help with breathing. 57 A client with severe back pain and hematuria is found to have hydronephrosis due to urolithiasis. The nurse anticipates which treatment will be done to relieve the obstruction? Correct answer: insertion of a nephrostomy tube Urolithiasis occurs when a stone forms in urinary system. Hydronephrosis develops when the stone has blocked the ureter and urine backs up and dilates and damages the kidney. Treatment allow urine to drain and relieve the obstruction in the ureter. PD is not needed cause kidney is functioning. Opioid analgesics are necessary for pain relief but do not treat the obstruction. 64 The nurse is evaluating fluid resuscitation attempts in the burn client. Which finding indicates adequate fluid resuscitation? Correct answer: Heart rate of 95 beats/minute Adequacy of fluid volume resuscitation can be evaluated by determining if urine output is at least 30 mL/hour, peripheral pulses are +2 or better, and the client is oriented to client, place, heart rate less than 120 beats/min and time. 70 A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse. Which assessment findings would be consistent with acute pancreatitis? Missed one answer: Diarrhea Grayish-blue discoloration at the flank is known as Grey-Turner's sign and occurs as a result of pancreatic enzyme leakage to cutaneous tissue from the peritoneal cavity. My have pain all of sudden the in stomach, may have tenderness with palpation. 71. The nurse is providing morning care to a client who has a closed chest tube drainage system to treat a pneumothorax. When the nurse turns the client to the side, the chest tube is accidentally dislodged from the chest. The nurse immediately applies sterile gauze over the chest tube insertion site. Which is the nurse's next action? Correct answer: Replace the chest tube system. When it comes dislodged from the insertion site, I would immediately applies sterile gauze over the site and call the HCP. I would keep the client in upright position. May attached new chest tube if requires insertion, may not be in this order. Check pulse oximetry readings for oxygen level for respiratory status. 74. A client who has had a total knee arthroplasty tells the nurse that there is pain with extension of the knee. The nurse should perform which action? Correct answer: Notify the health care provider. Extension pain is a common complaint of clients after knee arthroplasty, nurse should encourage the client to keep the knee extended and administer analgesics as needed. 93. The nurse provides instructions to a client with bilateral deformities of the joints of the fingers due to rheumatoid arthritis. When providing teaching about the disease process, the nurse should inform the client that the changes are most likely due to what type of response? Correct answer: Autoimmune Most likely cause for rheumatoid arthritis is activation of an autoimmune response. Thought to trigger antigen-antibody responses and release of lysosomes from phagocytic cells, which ultimately attack the cartilage and synovia, with resultant synovitis. 97. A health care provider prescribes 1 unit of packed red blood cells to be infused over 4 hours. The unit of blood contains 250 mL. The drop factor is 15 drops (gtt)/mL. The nurse should set the flow rate at how many drops per minute? Fill in the blank. Round your answer to the nearest whole number. Correct answer: 16gtt/min 250mlx15gtt=3750/240=15.62 round up 16gtt Saunders Nclex -RN question 100 set of 2 of 5 4. The nurse has given the client instructions about crutch safety. Which statement indicates that the client understands the instructions? Select all that apply. Correct answer: I should not use someone else's crutches I need to remove any scatter rugs at home I need to have spare crutches and tips available Use only crutches measured for the client, When assessing the home for safety, the nurse ensures client knows to remove any scatter rugs and don’t walk on highly waxed floors. 7. The nurse is reviewing the medical record for a client who has been diagnosed with Hodgkin's disease. The nurse should check which diagnostic test noted in the client's record to determine the stage of the disease? Correct answer: Positron emission topography (PET) scan Chronic progressive neoplastic disorder of lymphoid tissue. Characterized by painless enlargement of lymph nodes with progression to extralymphatic sites, such as the spleen and liver. PET scan with or without computed tomography is used to diagnose and determine the stage of the disease. 10. A client's electrocardiogram (ECG) strip shows atrial and ventricular rates of 70 complexes/minute. The PR interval is 0.16 second, the QRS complex measures 0.06 second, and the PP interval is slightly irregular. How should the nurse report this rhythm? Correct answer: Sinus dysrhythmia Sinus dysrhythmia has all of the characteristics of normal sinus rhythm except for the presence of an irregular PP interval. Because of phasic changes in the rate of firing of the sinoatrial node, which may occur with vagal tone and with respiration. Cardiac output is not affected. 14. The nurse has a prescription to give 30 mL of an antacid to a client through a feeding tube. Which is the priority nursing action? Correct answer: Assess tube placement. Tube placement is the priority to prevent aspiration and to ensure that medication delivery will be in the stomach. 17. The nurse is caring for a client with leukemia who is receiving intravenous chemotherapy. The nurse reviews the laboratory results and notes that the white blood cell count is 2000 mm3 (2 × 109/L), the platelet count is 150,000 mm3 (150 × 109/L), the clotting time is 10 minutes, and the ammonia level is 20 mcg/dL (12 mcmol/L). Which nursing action would be appropriate? Correct answer: Place the client on neutropenic precautions. Normal white blood cell count is 5000 to 10,000 mm, when neutropenic precautions need to be implemented when wbc drops, Bleeding precautions need to be initiated when the platelet count drops below 90,000 to 100,000 mm, The normal platelet count is 150,000 to 400,000 mm, normal clotting time is 8 to 15 minutes, normal ammonia level is 10 to 80 mcg/dL, 26. The nurse is evaluating the plan of care for a client with peptic ulcer disease (PUD) who is experiencing acute pain. The nurse determines that the expected outcomes have been met if the nursing assessment reveals which result? Correct answer: The client has eliminated any irritating foods from the diet. Expected outcomes for the client with PUD who is experiencing pain include elimination of irritating foods from the diet, effectiveness of prescribed medications to eliminate pain, self- reporting of absence of pain with medication, and an ability to sleep through the night without pain. The client who continues to be awakened by pain requires further modification of medication therapy, which may include adjustment of timing of histamine H2-receptor antagonist administration or an additional dose of antacid before the time when pain usually awakens the client. 31. The nurse is caring for a client after an above-the-knee amputation. The nurse assesses the residual (remaining) limb and expects to note which finding? Correct answer: Pink color to the skin flap Nurse's primary focus is to monitor for signs indicating that there is sufficient tissue perfusion and no hemorrhage. The skin flap at the end of the residual limb should be pink in a light- skinned person. 58. The nurse is providing teaching to a transgender female to male client who will be started on testosterone therapy. Which information should the nurse include in the teaching session? Select all that apply. Correct answer: Expect the clitoris to enlarge. Papanicolaou tests are no longer necessary. Liver enzymes and cholesterol levels will need to be monitored. Transitioning from female to male will be started on testosterone therapy to enhance masculinization. Changes are going to take place like physiological changes include deepening of the voice, clitoral growth, breast atrophy, increased libido, laryngeal prominence, weight gain, acne, and headaches. The patient period will stop at the first dose but then return after months so progesterone may be needed to stop menses. 65. The nurse is developing a teaching plan for a group of adolescents regarding the causes of acne. The nurse develops the plan based on which characteristics associated with acne? Select all that apply. Correct answer: The exact cause of acne is unknown Acne requires active treatment for control until it resolves Oily skin and a genetic predisposition may be contributing factors for acne The types of lesions in acne include comedones (open and closed), pustules, papules, and nodules. Acne is a chronic skin disorder that usually begins in puberty and is more common in males. Lesions develop on the face, neck, chest, shoulders, and back. Acne requires active treatment for control until it resolves. Oily skin and a genetic predisposition may be contributing factors. 66. The nurse has instructed a client in the foods that are best to consume on a low-fat diet. The nurse determines that the client understands this diet if the client indicates which food item is lowest in fat? Correct answer: Dry toast and strawberry jelly Toast without butter or margarine, contains the least amount of fat among the items in the options provided. Strawberry jelly contains calories but nominal fat. Saunders Nclex -RN question 100 set of 3 of 5 05. The health care provider prescribes cromolyn for the client with asthma. The nurse identifies that the client correctly understands the purpose of this medication when the client states that the medication will produce which effect? Correct answer: Suppress an allergic response Cromolyn is a first-line therapy for prophylactic treatment of asthma; it’s a mast cell stabilizer, antiasthmatic, and antiallergic. The medication acts in part by stabilizing the cytoplasmic membrane of mast cells, preventing release of histamine and other mediators. 19. On assessment during a well-baby visit, the nurse notes that a 6-month-old infant has crossed eyes. Which interpretation would the nurse make based on this finding? Correct answer: Surgical intervention may be necessary to realign weak eye muscles. Squint or crossed-eyes is a condition in which eyes are not aligned because of lack of coordination of the extraocular muscles. Which is condition the eyes are not aligned because of lack of coordination of the extraocular muscles. Normal finding in a young infant, shouldn’t be present after about age 4 months. Loss of vision can occur if not treated early. 39. Penicillin G procaine, 1,000,000 units IM (intramuscularly), is prescribed for a child with an infection. The medication label reads "1,200,000 units per 2 mL." The nurse has determined that the dose prescribed is safe. The nurse administers how many milliliters per dose to the child? Correct answer: 1.7 mL 1,000,000/1,200,000x2ml=1.7ml 42. The nurse is reviewing the plan of care for a child with a diagnosis of suspected appendicitis. The nurse would question which intervention if noted in the plan of care? Correct answer: Applying a heating pad to abdomen to promote pain relief Whenever appendicitis is suspected, the nurse can determine the most intense site of pain, located at McBurney's point, by palpation. Midway between the right anterior superior iliac crest and the umbilicus. Usually the location of greatest pain in the child. 49. Cardiac magnetic resonance imaging (MRI) is prescribed for a client. When providing teaching, what does the nurse include as one of the major advantages of this test? Correct answer: It doesn't require any radiation Cardiac MRI does not require any radiation to the client and is considered an extremely safe procedure. It also provides images in multiple planes with uniformly good resolution and not just in 1 to 2 planes. 75. The client with gastroesophageal reflux disease (GERD) has a new prescription for pantoprazole. Which instruction should the nurse provide to the client? Correct answer: Chew the pill thoroughly proton pump inhibitor, is a delayed-release medication and should be swallowed whole. Headache is a potential side effect 96. A client is on continuous mechanical ventilation (CMV) and the high-pressure alarm sounds. Which action should the nurse take to eliminate the problem? Correct answer: Check the ventilator circuit for any disconnections High-pressure alarms can be triggered by increased airway resistance caused by excess secretions in the airway, biting the tube, coughing, bronchospasm, a kinked ventilator circuit, or excess condensation of water in the ventilator tubing. Emptied extra water from the tubing. Alarms should never be silenced until the cause has been identified and corrected. Saunders Nclex -RN question 100 set of 4 of 5 2. The nurse is teaching the client about risk factors for skin cancer. Which statements by the client indicate that teaching was successful? Select all that apply. Correct answer I got: 1.I have to avoid excessive exposure to sunlight 3. I am at higher risk for skin cancer because my mother had one 4. I am at higher risk for skin cancer because I am 20 years old Options 1 and 3 describe risk factors for skin cancer. Additional risk factors for skin cancer include age greater than 60 years, light-colored skin, and occupation exposure to arsenic, which is commonly used in pest control. 5. The nurse notes redness, warmth, and a yellowish drainage at the insertion site of a central venous catheter in a client receiving total parenteral nutrition. What is the nurse's initial action? Correct answer: 4. Evaluate for signs of septicemia Redness, warmth, and purulent drainage are signs of an infection, not of an allergic reaction. Infiltration causes the surrounding tissue to become cool and pale. An infection of a central venous catheter site can lead to septicemia. The nurse should assess for signs of septicemia and then notify the HCP so that all of the assessment data can be reported. If infection is suspected, the infusion should be stopped. Diphenhydramine is prescribed for allergic reactions. 19. The nurse is caring for a client with a dry suction chest drainage system. During assessment of the drainage system, what should the nurse expect to find? Select all that apply. Correct answer: 1. The dry suction control regulation set to the prescribed amount 2. The water filled suction control chamber filled to the prescribed amount 4. Continuous bubbling in the water seal chamber when the system is connected to suction 5.The drainage in the collection chamber marked each shift to monitor the amount of drainage Two types of chest drainage systems: the wet and dry drainage system. Dry drainage system. On routine assessment of the system, the nurse should look at the different chambers, check the dry suction control regulation and make sure it is set to the prescribed amount, look for the orange floater ball to appear in the window; this indicates that the suction is being applied correctly, tidaling check the water seal chamber, there should be water in the chamber, If continuous bubbling is noted or the bubbling increases, an air leak may be present and the connections should be checked. In a dry drainage system, water is not added to the suction control chamber. The drainage collection chamber should be monitored and marked each shift to monitor the amount of drainage, if any 25. The emergency department nurse is preparing a plan for initial care of a client with a diagnosis of hyperosmolar hyperglycemic syndrome (HHS). The nurse recognizes that the hyperglycemia associated with this disorder results from which occurrence? Correct answer: Increased production of glucose Hyperglycemia from decreased use and increased production of glucose. Increased use of glucose and increase of insulin would most likely cause hypoglycemia. 43. The nurse is caring for a client with Addison's disease. The client asks the nurse about the risks associated with this disease, specifically about addisonian crisis. Regarding prevention of this complication, how should the nurse inform the client? Correct answer: You need to increase salt in your diet, particularly during stressful situations Result of adrenocortical insufficiency is cause of Addison’s disease, and management with meds focused on treating the underlying cause. Hormone therapy is used for replacement like glucocorticoid and mineralocorticoid both make up hydrocortisone properties and needs to be taken 3 times daily, 2/3 need to be taking while awake. Fludrocortisone take once in morning. Salt additives are necessary during times of stress, to compensate for excess heat or humidity as a result of the condition. There needs to be an increased dose of cortisol given for stressful situations such as surgery or hospitalization. 45. The nurse caring for a client diagnosed with inflammatory bowel disease (IBD) recognizes that which classifications of medications may be prescribed to treat the disease and induce remission? Select all that apply. Correct answer: Anticrobial, Corticosteroid, aminosalicylate, biological therapy, and immununosuppressant. treatment for IBD decrease the inflammation and maintain a remission. Five classes are used to treat IBD, antimicrobials, corticosteroids, aminosalicylates, biological and targeted therapy, and immunosuppressants. Depending on severity treated with "step-up uses less toxic therapies like aminosalicylates and antimicrobials) " or "step-down" approach uses biological and targeted therapy first. 52. The nurse works with high-risk clients in an urban outpatient setting. Which groups should be tested for human immunodeficiency virus (HIV)? Select all that apply. Correct answer: People with sexually transmitted infections (STIs) People who have had frequent episodes of pneumonia HIV can cause acquired immunodeficiency syndrome, that’s viral disease that destroys T cells, thereby increasing susceptibility to infection and malignancy. Injection drug abusers, prostitution, frequent episodes of pneumonia, people who received a blood transfusion and males and females with STIs are high-risk groups that should be tested for HIV per the Centers for Disease Control and Prevention's recommendations. 63. A client who has had a stroke (brain attack) has residual dysphagia. When a diet prescription is initiated, the nurse should take which actions? Select all that apply. Correct answer: Thickening liquids to the consistency of oatmeal Placing food on the unaffected side of the mouth Allowing plenty of time for chewing and swallowing Dysphagia patient is started on a diet after the gag and swallow reflexes have returned. Assisted with meals as needed, and given a lot time to chew and swallow. Food placed on unaffected side of mouth. Liquids are thickened to avoid aspiration. Patient is never left alone cause risk of aspiration. 70. The nurse is monitoring the client with a serum calcium level of 6.2 mg/dL (1.55 mmol/L). Which findings should the nurse assess for in the client? Select all that apply. Correct answer: Irritability, Muscle cramps, Tingling sensations, Hyperactive reflexes and Memory impairment Normal serum calcium level is 9 to 10.5 mg/dL determine that the client is experiencing hypocalcemia. Signs of hypocalcemia tingling sensations, hyperactive reflexes, neuromuscular excitability, muscle cramps, tetany, seizures, insomnia, irritability, memory impairment, anxiety and a positive Trousseau's or Chvostek's sign. 73. The nurse performs an assessment on a client admitted with contact dermatitis. Which signs and symptoms should the nurse look for? Correct answer: Lesions with well-defined geometric margins Contact dermatitis findings include skin lesions with well-defined geometric margins 79. The nurse has inserted a nasogastric (NG) tube to the level of the oropharynx and has repositioned the client's head in a flexed-forward position. The client has been asked to begin swallowing. The nurse starts to slowly advance the NG tube with each swallow. The client begins to cough, gag, and choke. Which actions should the nurse take that will result in proper tube insertion and promote client relaxation? Select all that apply. Correct answer: Pull the tube back slightly Instruct the client to breathe slowly Assist the client to take sips of water Check the back of the pharynx using a tongue blade and flashlight When inserting a NG tube it pass through the oropharynx, the gag reflex is stimulated, cause coughing, gagging, or choking, Instead of passing through to the esophagus, ng tube may coil around in the oropharynx, or enter the larynx and obstruct the airway. Because the tube may enter the larynx and obstruct the airway, pulling back slightly will remove it from the larynx; advancing may position it in the trachea. Swallowing closes the epiglottis over the trachea and helps move the tube into the esophagus. Slow breathing will help with relaxing, will reduces the gag response. The nurse should check the back of the client's throat to note whether the tube has coiled. The tube may be advanced after the client relaxes. 80. The nurse is planning to instruct a Hispanic American client about nutrition and dietary restrictions. What factors should the nurse keep in mind when developing this client's plan of care? Select all that apply. Correct answer: They view food as a primary form of socialization Any occasion is seen as a time to celebrate with food Any occasion is seen as a time to celebrate with food and enjoy the companionship of family and friends with in Hispanic American homes. 85. A client is undergoing a 2-hour glucose tolerance test. The nurse assesses for which client factors that can interfere with the test period results? Select all that apply. Correct answer: Experiencing stress Eating a small snack or candy during the test period Having an episode of diarrhea before the test period Being unable to eat the entire test meal or vomiting some or all of the meal Inaccurate test findings include experiencing stress, unable to eat the entire test meal, vomiting during the test period, eating a small snack or candy during the test period. 86. The nurse walking in a downtown business area witnesses a worker fall from a ladder. The nurse rushes to the victim, who is unresponsive. A layperson is attempting to perform resuscitative measures. The nurse should intervene if which action by the layperson is noted? Correct answer: Use of the head tilt–chin lift Jaw thrust maneuver should be used during basic life support to open the airway. Head tilt–chin lift produces hyperextension of the neck and could cause complications if a neck injury is present, and scene should be checked for safety. 88. The nurse is caring for an older client. The nurse should anticipate that medication dosages will be further adjusted if the client has dysfunction of which organ? Correct answer: liver Important function of the liver is break down medications and toxic substances. Older client with liver disease are at increased risk for toxic medication effects they need be monitored carefully for adverse effects. 89. The nurse is caring for a client with acute pancreatitis. Which finding should the nurse expect to note when reviewing the laboratory results? Correct answer: Elevated serum lipase level Serum lipase level is elevated in the presence of pancreatic cell injury. Serum trypsin and amylase levels are also elevated in pancreatic injury. Saunders Nclex -RN question 100 set of 5 of 5 2. The nurse explains to a client why telemonitoring is needed. What response by the client indicates a need for further instruction? Correct answer: 1. Telemonitoring ignores artifact In fact, accurate interpretation of heart rhythm is difficult when artifact is present. 14. The nurse is planning to teach a client with malabsorption syndrome about the necessity of following a low-fat diet. The nurse develops a list of high-fat foods to avoid and should include which food items on the list? Select all that apply. Correct Answer: Fruits and vegetables tend to be lower in fat because they do not come from animal sources. 64. The nurse is planning care for a client returning from the operating room after having an autograft applied to the right lower extremity. Which nursing intervention is focused on promoting graft "take"? Correct answer: Leave the dressing intact for 3 to 5 days. After surgery, graft sites are immobilized with bulky cotton pressure dressing for 3 to 5 days to allow vascularization, or "take," of the newly grafted skin. Elevation and complete rest of the grafted area is required to allow blood vessels to connect the graft. 65. The nurse is caring for a client with a dry suction chest drainage system. During assessment of the drainage system, what should the nurse expect to find? Select all that apply. Correct answer: The dry suction control regulation set to the prescribed amount The water filled suction control chamber filled to the prescribed amount (I missed this one) The drainage in the collection chamber marked each shift to monitor the amount of drainage Dry drainage system. On routine assessment of the system, the nurse should look at the different chambers, check the dry suction control regulation and make sure it is set to the prescribed amount, look for the orange floater ball to appear in the window; this indicates that the suction is being applied correctly, tidaling check the water seal chamber, there should be water in the chamber, If continuous bubbling is noted or the bubbling increases, an air leak may be present and the connections should be checked. In a dry drainage system, water is not added to the suction control chamber. The drainage collection chamber should be monitored and marked each shift to monitor the amount of drainage, if any 75. The nurse cares for a client prior to surgery. The client asks the nurse, "What is the advantage of spinal anesthesia over general anesthesia for controlling my pain?" Which is the best response by the nurse? Correct answer: Your pain can be managed without making you as sleepy An advantage of spinal anesthesia (a regional anesthesia) is pain control without any accompanying cognitive dysfunction. [Show More]

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