A nurse is assessing a newly admitted client with a history of chronic heart failure who has new onset confusion after forgetting to take his medications for a few days. The client has peripheral edema, mild shortness of breath, and bilateral crackles in the lung bases. Which of the following assessments is the priority for the nurse?

Capillary refill and depth of peripheral edema

Abdominal sounds and obtain a BNP level

Neurological status and obtain electrolyte levels

Skin turgor and measure intake & output (I&O)

Answer and Explanation

The Correct Answer is C

A. Capillary refill and depth of peripheral edema: While these assessments are important for evaluating peripheral circulation and fluid status, they are not as immediately critical given the client's new onset of confusion and respiratory symptoms.
B. Abdominal sounds and obtain a BNP level: Assessing abdominal sounds and BNP (B-type natriuretic peptide) levels is useful for diagnosing heart failure exacerbations but is secondary to addressing the client's acute confusion and potential electrolyte imbalances.
C. Neurological status and obtain electrolyte levels: This is the correct choice. New onset confusion can be indicative of electrolyte imbalances or acute exacerbations related to heart failure. Monitoring neurological status and electrolyte levels is crucial to address potential causes of confusion and ensure proper treatment.
D. Skin turgor and measure intake & output (I&O): While skin turgor and I&O are relevant for assessing fluid status, the priority should be addressing the acute change in mental status and potential underlying causes such as electrolyte imbalances.

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Correct Answer is C

Explanation

A. Non-steroidal anti-inflammatory drugs: These typically cause gastrointestinal upset and potential bleeding but are less likely to cause respiratory depression, constipation, or hypotension.
B. Cyclooxygenase-2 inhibitors: These are a subset of NSAIDs with fewer gastrointestinal side effects but do not generally cause respiratory depression or hypotension.
C. Opioid analgesics: This is the correct choice. Opioid analgesics are known to cause respiratory depression, constipation, nausea, vomiting, and hypotension.
D. Non-opioid pain medications: These include medications like acetaminophen and NSAIDs, which are less likely to cause respiratory depression or hypotension.

A. Facilitating sodium and potassium exchange B. DNA and prothrombin synthesis C. Regulating calcium and phosphorus metabolism D. Production of beta carotene

Correct Answer is C

Explanation

A. Facilitating sodium and potassium exchange: This is not related to vitamin D. Sodium and potassium exchange is primarily managed by other mechanisms in the body.
B. DNA and prothrombin synthesis: This role is more associated with vitamins like B12 and K, not vitamin D.
C. Regulating calcium and phosphorus metabolism: This is the correct choice. Vitamin D plays a crucial role in the absorption of calcium and phosphorus from the diet and their metabolism in the body.
D. Production of beta carotene: Beta carotene is a precursor to vitamin A, not related to vitamin D's functions.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is experiencing respiratory depression, constipation, nausea and vomiting, and hypotension after receiving pain medication. Which class of analgesics did this client most likely receive?

Correct Answer is C

Explanation

The nurse is providing teaching to the client about the use of vitamins and supplements. The nurse would state that vitamin D has a major role in which process?

Correct Answer is C

Explanation

A nurse reviews a client's laboratory report and notes that the client's serum phosphorus (phosphate) level is 1.8 mg/dL. Which condition most likely caused this serum phosphorus level?

Which of the following assessment findings should alert the nurse that a client's IV has infiltrated? (Select All That Apply)

A nurse is providing education in a community setting to several clients taking daily calcium supplements and encourages them to drink 2,500 mL of fluid daily. The nurse explains that this intervention is important to prevent which complication?

The nurse is caring for a client being treated for fluid volume excess. Which assessment finding indicates that treatment has been effective?

An unresponsive client was brought to the emergency room and had an arterial blood gas drawn. Ten minutes later, the laboratory calls with the following results: PaO2 74%, pH 7.22, PaCO2 85 mm Hg, and HCO3 23 mEq/L. The nurse interprets the results as indicating which imbalance?

The nurse is taking a medication history of a client scheduled for surgery the next morning. Which medication requires the nurse to immediately notify the surgeon?

A nurse asks the unlicensed assistive personnel (UAP) to assist in determining the fluid status of a client. Which of the following actions should the nurse delegate to the UAP? (Select All That Apply)