Nokea
The physician has ordered intubation and mechanical ventilation for a client with periods of apnea following a closed head injury. Arterial blood gases reveal a pH of 7.47, PCO2 of 28, and HCO3 of 23. These findings indicate that the client has:
- A. Respiratory acidosis
- B. Respiratory alkalosis
- C. Metabolic acidosis
- D. Metabolic alkalosis
Correct Answer: B
Rationale: A pH of 7.47 and PCO2 of 28 indicate respiratory alkalosis, likely due to hyperventilation from the head injury.
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The physician has ordered atropine sulfate 0.4 mg IM before surgery. The medication is supplied in 0.8 mg per milliliter. The nurse should administer how many milliliters of the medication?
- A. 0.25 mL
- B. 0.5 mL
- C. 1.0 mL
- D. 1.25 mL
Correct Answer: B
Rationale: To calculate: 0.4 mg ÷ 0.8 mg/mL = 0.5 mL, the correct dose to administer.
When assisting a client with range-of-motion exercises, which movements should be carried out on the client's elbows? Select all that apply.
- A. Supination.
- B. Flexion.
- C. Circumduction
- D. Pronation
- E. Extension.
- F. Hyperextension.
Correct Answer: A,B,D,E
Rationale: Elbow range-of-motion includes flexion (B), extension (E), supination (A), and pronation (D). Circumduction (C) is not possible at the elbow, and hyperextension (F) is not a standard motion for this joint.
A nurse is caring for a 37-year-old woman with metastatic ovarian cancer admitted for nausea and vomiting. The physician orders total parenteral nutrition (TPN), a nutritional consult, and diet recall. Which of the following is the BEST indication that the patient’s nutritional status has improved after 4 days?
- A. The patient eats most of the food served to her.
- B. The patient has gained 1 pound since admission.
- C. The patient’s albumin level is 4.0 mg/dL.
- D. The patient’s hemoglobin is 8.5 g/dL.
Correct Answer: C
Rationale: albumin levels are best indicators of long-term nutritional status
Which assessment finding in a client with COPD indicates to the nurse that the respiratory problem is chronic?
- A. Wheezing on exhalation
- B. Productive cough
- C. Clubbing of fingers
- D. Cyanosis
Correct Answer: C
Rationale: Clubbing of fingers is a sign of chronic hypoxia, indicative of long-standing COPD, unlike wheezing or cough, which can occur in acute or chronic stages.
A nurse manager is educating a group of nursing students about the Patient's Bill of Rights. The nurse knows that the student nurses have an understanding of the bill when one of the nurses makes which statement?
- A. Clients have the right to view their medical records but may not copy any of the information contained in the records.
- B. Clients may be declined care at an emergency department or need preauthorization for care if they do not have premium-level insurance.
- C. Clients have the right to a quick and objective review of any claim that they levy against a health care facility, physician, or health care plan.
- D. It is the admitting nurse's job to verify the client's past medical history, medications, and treatments, even if the client refuses to cooperate in giving the information.
Correct Answer: C
Rationale: The Patient’s Bill of Rights includes the right to a fair review of claims against healthcare providers. Other options are incorrect or misrepresent client rights.