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Ati lpn med surg level 3
Total Questions : 36
Showing 10 questions, Sign in for moreA nurse is caring for a client who has hypertension and is to start taking atenolol. The nurse should instruct the client to monitor for which of the following findings as an adverse effect of this medication?
A nurse is assisting with the care of a client who was admitted to the telemetry unit after he experienced chest pain, dyspnea and diaphoresis. Which of the following ECG findings is a manifestation of acute myocardial infarction?
A nurse is collecting data from a client who has left-sided heart failure. Which of the following findings should the nurse expect?
A nurse is assisting with collecting data on a client who is on a continuous ECG monitor. The client's ECG tracing shows no identifiable P waves and an irregular ventricular rate. The nurse should recognize the client is experiencing which of the following cardiac dysrhythmias?
Client admitted to the ED with palpitations, fatigue, weakness, and nocturia.
Client reports awakening two to three times each night to urinate. Breath sounds scattered crackles heard bilaterally.
Client reports a dry, hacking cough, especially at night.
Apical heart rate rapid and irregular. Audible S3 gallop. Color pale, skin cool and clammy to touch
- Blood Pressure: 142/88 mm Hg
- Heart Rate: 120/min, irregular
- Respiratory Rate: 26/min
- Oxygen Saturation: 90% on room air
BNP (B-type natriuretic peptide): 140 pg/ml (<100 pg/ml)
A nurse in the emergency department is assisting with the care of a client.
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to collect data about the client's progress. Select the Condition first, Actions 2nd and Monitoring last.
Explanation
Condition:
Left-sided heart failure: The client is presenting with classic symptoms of left-sided heart failure, such as fatigue, weakness, nocturia (awakening at night to urinate), crackles in the lungs (due to fluid accumulation), a rapid and irregular apical heart rate, an audible S3 gallop, and a dry, hacking cough. These are indicative of pulmonary congestion, which is typical in left-sided heart failure.
Actions to take:
- Administer supplemental oxygen: Since the client is experiencing pulmonary congestion with crackles and a rapid irregular heart rate, supplemental oxygen will help to improve oxygenation and alleviate dyspnea associated with heart failure.
- Elevate the head of the client’s bed: Elevating the head of the bed will promote better lung expansion, reduce pulmonary congestion, and ease breathing, which is beneficial in managing the symptoms of left-sided heart failure.
Parameters to monitor:
- Urine output: Monitoring urine output helps assess the effectiveness of diuretic therapy and overall kidney function. In heart failure, decreased perfusion to the kidneys may lead to fluid retention, so monitoring urine output is essential in evaluating fluid balance.
- Weight: Daily weight monitoring is important in heart failure management to detect fluid retention. A rapid weight gain may indicate worsening heart failure, while a reduction in weight could signify successful diuresis and fluid management.
A nurse is performing an electrocardiogram on a client who has been experiencing chest pain over the past week or so. Which of the following statements should the nurse make to the patient prior to the test?
A 78-year-old client reports nausea and diarrhea for the past 48 hr The client states, "I felt dizzy getting out of bed this morning and fell." The client reports pain in right hip. Pedal pulses are +1 bilaterally, feet are warm to touch. Neck veins are flat when the client is supine. The client’s skin is dry to touch, and tents for 2 min after pinching.
History of heart failure
History of iron-deficiency anemia
Spironolactone 50 mg PO BID
Ferrous sulfate 60 mg PO QD
Temperature: 36.8°C (98.2°F)
Blood Pressure: 88/54 mm Hg
Heart Rate: 112/min
Respiratory Rate: 22/min
Oxygen Saturation: 94% on room air
A nurse is assisting with the admission of a client to a medical surgical unit following a fall at home.
Diagnostic results:
Complete blood count:
|
Test: |
Results: |
Reference ranges: |
|
White Blood Cell Count (WBC) |
7000/µL |
4,000-11,000/µL |
|
Hemoglobin (Hb) |
10.2 g/dl |
12.0-15.5 g/dL |
|
Hematocrit (Hct) |
32% |
37-47% |
|
Platelets |
250,000/µL |
150,000-450,000/µL |
Biochemical tests:
|
Test |
Result |
Reference range |
|
Sodium (Na): |
132 |
135-145 mmol/L |
|
Potassium (K): |
5.8 |
3.5-5.0 mmol/L |
|
Chloride (Cl): |
97 |
98-106 mmol/L |
|
Creatinine: |
1.5 |
0.6-1.2 mg/dL |
|
Blood Urea Nitrogen (BUN): |
40 |
7-20 mg/dL |
The nurse is discussing the client's treatment plan with the provider. For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client. Each column should only be selected once.
Explanation
. Obtain an x-ray of the right hip:
- Anticipated: After a fall, especially in an elderly client with a history of dizziness, it's important to rule out a hip fracture, a common and serious injury in this population.
2. Administer iron supplement
- Anticipated: Maintaining adequate iron supplementation is important to address the client's chronic iron-deficiency anemia. This helps to support red blood cell production.
3. Administer spironolactone
- Contraindicated: Administering spironolactone is contraindicated because the client’s potassium level is elevated at 5.8 mmol/L, indicating hyperkalemia. Spironolactone, a potassium-sparing diuretic, could further exacerbate this condition.
4. Administer supplemental oxygen PRN
- Nonessential: Administering supplemental oxygen is nonessential at this time because the client’s oxygen saturation is 94% on room air, which is within the normal range.
5. Administer an IV fluid bolus
- Anticipated: Administering an IV fluid bolus is anticipated due to the client’s signs of dehydration (e.g., tenting skin, dry skin, low blood pressure) and recent history of nausea and diarrhea.
A nurse is preparing to administer hydrochlorothiazide 25 mg PO every 8 hr. The amount available is hydrochlorothiazide 50 mg/tab. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Explanation
Desired dose: 25 mg
Available dose: 50 mg/tab
Formula:
Tabletstoadminister=Desireddose ÷ Availabledosepertablet
= 25mg ÷ 50mg/tab
= 0.5 tablets
Therefore, the nurse should administer 0.5 tablet(s) per dose.
A nurse is reinforcing teaching with a newly licensed nurse about reading a client's ECG tracing. The nurse should include in the teaching that the P wave represents which of the following cardiac electrical activities?
A nurse is preparing to perform a 12-lead electrocardiogram (ECG). Which of the following instructions should the nurse provide to the client?
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