The nurse has just admitted a client with severe depression. From which focus should the nurse identify a priority nursing diagnosis? A. Nutrition B. Elimination C. Activity D. Safety Correct Answer: D. Safety Safety is a priority of care for the depressed client. Precautions to prevent suicide… Read More »
A 28-year-old male has been found wandering around in a confusing pattern. The male is sweaty and pale. Which of the following tests is most likely to be performed first? A. Blood sugar check B. CT scan C. Blood cultures D. Arterial blood gases Correct Answer: A. Blood… Read More »
A patient is admitted to the hospital with a diagnosis of primary hyperparathyroidism. A nurse checking the patient’s lab results would expect which of the following changes in laboratory findings? A. Elevated serum calcium B. Low serum parathyroid hormone (PTH) C. Elevated serum vitamin D D. Low urine calcium … Read More »
A patient is admitted to the same-day surgery unit for a liver biopsy. Which of the following laboratory tests assesses coagulation? Select all that apply. A. Partial thromboplastin time B. Prothrombin time C. Platelet count D. Hemoglobin Correct Answer: A, B, & C Prothrombin time, partial thromboplastin time,… Read More »
Myrna, a 52-year-old client with a fractured left tibia, has a long leg cast and she is using crutches to ambulate. Nurse Joy assesses for which sign and symptom that indicates complication associated with crutch walking? A. Left leg discomfort B. Weak biceps brachii C. Triceps muscle spasm D. Forearm weakness… Read More »
Nurse Zeny is caring for a client in an acute Addisonian crisis. Which laboratory data would the nurse expect to find? A. Hyperkalemia B. Reduced blood urea nitrogen (BUN) C. Hypernatremia D. Hyperglycemia Correct Answer: A. Hyperkalemia In adrenal insufficiency, the client has hyperkalemia due to reduced… Read More »
The LPN/LVN, under your supervision, is providing nursing care for a patient with GBS. What observation would you instruct the LPN/LVN to report immediately? A. Complaints of numbness and tingling. B. Facial weakness and difficulty speaking. C. Rapid heart rate of 102 beats per minute. D. Shallow respirations and decreased breath sounds.… Read More »
An 18-year-old male client admitted with heat stroke begins to show signs of disseminated intravascular coagulation (DIC). Which of the following laboratory findings is most consistent with DIC? A. Low platelet count B. Elevated fibrinogen levels C. Low levels of fibrin degradation products D. Reduced prothrombin time Correct Answer:… Read More »
A female client tells nurse Nikki that she has been working hard for the last 3 months to control her type 2 diabetes mellitus with diet and exercise. To determine the effectiveness of the client’s efforts, the nurse should check: A. Urine glucose level. B. Fasting blood glucose level. C. Serum fructosamine… Read More »
A nurse is caring for a patient with a platelet count of 20,000/microliter. Which of the following is an important intervention? A. Observe for evidence of spontaneous bleeding. B. Limit visitors to family only. C. Give aspirin in case of headaches. D. Impose immune precautions. Correct Answer:… Read More »