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Questions and Answers
After teaching a patient with COPD the proper technique for using a metered-dose inhaler (MDI), which action by the nurse best evaluates the effectiveness of the education?
After teaching a patient with COPD the proper technique for using a metered-dose inhaler (MDI), which action by the nurse best evaluates the effectiveness of the education?
A patient with heart failure presents with new onset peripheral edema, weight gain, and increased dyspnea. Which combination of interventions should the nurse prioritize?
A patient with heart failure presents with new onset peripheral edema, weight gain, and increased dyspnea. Which combination of interventions should the nurse prioritize?
A patient with heart failure presents with new onset peripheral edema, weight gain, and increased dyspnea. Which combination of interventions should the nurse prioritize?
A patient with heart failure presents with new onset peripheral edema, weight gain, and increased dyspnea. Which combination of interventions should the nurse prioritize?
A patient with metabolic syndrome is struggling to make lifestyle changes. Which approach is most likely to promote long-term adherence?
A patient with metabolic syndrome is struggling to make lifestyle changes. Which approach is most likely to promote long-term adherence?
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A patient with chronic kidney disease has a potassium level of 6.5 mEq/L. Which combination of interventions should the nurse anticipate? (Select all that apply)
A patient with chronic kidney disease has a potassium level of 6.5 mEq/L. Which combination of interventions should the nurse anticipate? (Select all that apply)
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A patient with a history of stroke develops sudden right-sided weakness and aphasia. Which action should the nurse take first?
A patient with a history of stroke develops sudden right-sided weakness and aphasia. Which action should the nurse take first?
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A patient with asthma presents with severe wheezing, use of accessory muscles, and difficulty speaking. Which treatment should the nurse prepare to administer first?
A patient with asthma presents with severe wheezing, use of accessory muscles, and difficulty speaking. Which treatment should the nurse prepare to administer first?
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A patient with pneumonia is having difficulty clearing secretions. Which combination of interventions would be most effective?
A patient with pneumonia is having difficulty clearing secretions. Which combination of interventions would be most effective?
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A patient taking a beta-blocker for hypertension reports dizziness and fatigue. Which assessment finding would be most concerning?
A patient taking a beta-blocker for hypertension reports dizziness and fatigue. Which assessment finding would be most concerning?
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A patient with hypothyroidism has a TSH level of 12 mIU/L despite levothyroxine therapy. Which factor is most likely contributing to the elevated TSH?
A patient with hypothyroidism has a TSH level of 12 mIU/L despite levothyroxine therapy. Which factor is most likely contributing to the elevated TSH?
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A patient with chronic kidney disease has a GFR of 25 mL/min. Which set of dietary recommendations should the nurse provide?
A patient with chronic kidney disease has a GFR of 25 mL/min. Which set of dietary recommendations should the nurse provide?
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A patient with epilepsy experiences a tonic-clonic seizure lasting 6 minutes. Which sequence of interventions should the nurse implement?
A patient with epilepsy experiences a tonic-clonic seizure lasting 6 minutes. Which sequence of interventions should the nurse implement?
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A patient with tuberculosis is non-adherent to the medication regimen. Which strategy is most likely to improve compliance?
A patient with tuberculosis is non-adherent to the medication regimen. Which strategy is most likely to improve compliance?
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A patient presents with chest pain, diaphoresis, and ST-segment elevation on ECG. Which set of interventions should the nurse prioritize?
A patient presents with chest pain, diaphoresis, and ST-segment elevation on ECG. Which set of interventions should the nurse prioritize?
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A patient with type 1 diabetes is scheduled for surgery. Which perioperative management plan is most appropriate?
A patient with type 1 diabetes is scheduled for surgery. Which perioperative management plan is most appropriate?
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A patient with acute renal failure has a serum creatinine of 4.5 mg/dL and oliguria. Which combination of interventions should the nurse anticipate?
A patient with acute renal failure has a serum creatinine of 4.5 mg/dL and oliguria. Which combination of interventions should the nurse anticipate?
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A patient with Cushing's syndrome is preparing for adrenalectomy. Which preoperative education is most important for the nurse to provide?
A patient with Cushing's syndrome is preparing for adrenalectomy. Which preoperative education is most important for the nurse to provide?
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A patient with a C5 spinal cord injury develops sudden bradycardia, hypertension, and diaphoresis above the level of injury. Which action should the nurse take first?
A patient with a C5 spinal cord injury develops sudden bradycardia, hypertension, and diaphoresis above the level of injury. Which action should the nurse take first?
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A patient with cystic fibrosis has thick, tenacious sputum. Which combination of interventions would be most effective in mobilizing secretions?
A patient with cystic fibrosis has thick, tenacious sputum. Which combination of interventions would be most effective in mobilizing secretions?
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A patient with atrial fibrillation has a ventricular rate of 150 bpm and is hemodynamically stable. Which sequence of interventions should the nurse anticipate?
A patient with atrial fibrillation has a ventricular rate of 150 bpm and is hemodynamically stable. Which sequence of interventions should the nurse anticipate?
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A patient with diabetic ketoacidosis has a blood glucose of 600 mg/dL and a pH of 7.1. Which set of interventions should the nurse prioritize? (Select one)
A patient with diabetic ketoacidosis has a blood glucose of 600 mg/dL and a pH of 7.1. Which set of interventions should the nurse prioritize? (Select one)
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A patient with Addison’s disease presents with weakness, hypotension, and electrolyte imbalances. Which combination of interventions is most appropriate?
A patient with Addison’s disease presents with weakness, hypotension, and electrolyte imbalances. Which combination of interventions is most appropriate?
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A patient with glomerulonephritis exhibits hematuria, proteinuria, and edema. Which set of interventions should the nurse implement?
A patient with glomerulonephritis exhibits hematuria, proteinuria, and edema. Which set of interventions should the nurse implement?
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A patient with a subdural hematoma develops unequal pupils and decreased level of consciousness. Which sequence of interventions should the nurse prioritize?
A patient with a subdural hematoma develops unequal pupils and decreased level of consciousness. Which sequence of interventions should the nurse prioritize?
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A patient with COPD experiences an acute exacerbation with increased dyspnea and purulent sputum. Which combination of interventions is most appropriate?
A patient with COPD experiences an acute exacerbation with increased dyspnea and purulent sputum. Which combination of interventions is most appropriate?
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A patient with heart failure develops acute pulmonary edema. Which set of interventions should the nurse implement first?
A patient with heart failure develops acute pulmonary edema. Which set of interventions should the nurse implement first?
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A patient with type 2 diabetes has a fasting blood glucose of 180 mg/dL despite maximum oral medication doses. Which treatment modification should the nurse anticipate?
A patient with type 2 diabetes has a fasting blood glucose of 180 mg/dL despite maximum oral medication doses. Which treatment modification should the nurse anticipate?
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A patient with hyperthyroidism develops thyroid storm. Which combination of interventions is most critical?
A patient with hyperthyroidism develops thyroid storm. Which combination of interventions is most critical?
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A patient with polycystic kidney disease presents with severe flank pain and hematuria. Which diagnostic test should the nurse prepare the patient for first?
A patient with polycystic kidney disease presents with severe flank pain and hematuria. Which diagnostic test should the nurse prepare the patient for first?
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A patient with traumatic brain injury has an ICP of 25 mmHg and a CPP of 55 mmHg. Which intervention should the nurse implement first?
A patient with traumatic brain injury has an ICP of 25 mmHg and a CPP of 55 mmHg. Which intervention should the nurse implement first?
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A patient with emphysema has a PaCO2 of 60 mmHg and a pH of 7.30. Which intervention is most appropriate?
A patient with emphysema has a PaCO2 of 60 mmHg and a pH of 7.30. Which intervention is most appropriate?
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A patient with atrial fibrillation is started on warfarin. Which combination of patient education topics is most important?
A patient with atrial fibrillation is started on warfarin. Which combination of patient education topics is most important?
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A patient with diabetic ketoacidosis has a potassium level of 2.8 mEq/L. Which modification to the standard DKA protocol is most appropriate?
A patient with diabetic ketoacidosis has a potassium level of 2.8 mEq/L. Which modification to the standard DKA protocol is most appropriate?
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A patient with hypothyroidism reports fatigue and weight gain despite levothyroxine therapy. Which factor should the nurse assess first?
A patient with hypothyroidism reports fatigue and weight gain despite levothyroxine therapy. Which factor should the nurse assess first?
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A patient with chronic kidney disease stage 4 is considering treatment options. Which factor is most important for the nurse to assess when discussing dialysis modalities?
A patient with chronic kidney disease stage 4 is considering treatment options. Which factor is most important for the nurse to assess when discussing dialysis modalities?
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A patient with a spinal cord injury at T6 develops autonomic dysreflexia. Which intervention should the nurse implement first? (Select one)
A patient with a spinal cord injury at T6 develops autonomic dysreflexia. Which intervention should the nurse implement first? (Select one)
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A patient with tuberculosis is started on isoniazid. Which laboratory value should the nurse monitor most closely?
A patient with tuberculosis is started on isoniazid. Which laboratory value should the nurse monitor most closely?
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A patient with unstable angina develops chest pain unrelieved by sublingual nitroglycerin. Which intervention should the nurse prepare to implement next?
A patient with unstable angina develops chest pain unrelieved by sublingual nitroglycerin. Which intervention should the nurse prepare to implement next?
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A patient with type 1 diabetes experiences recurrent hypoglycemia. Which modification to the insulin regimen is most appropriate?
A patient with type 1 diabetes experiences recurrent hypoglycemia. Which modification to the insulin regimen is most appropriate?
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A patient with Cushing’s syndrome is preparing for bilateral adrenalectomy. Which postoperative complication should the nurse monitor for most closely?
A patient with Cushing’s syndrome is preparing for bilateral adrenalectomy. Which postoperative complication should the nurse monitor for most closely?
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A patient with a C6 spinal cord injury reports a severe headache and blurred vision. Which action should the nurse take first?
A patient with a C6 spinal cord injury reports a severe headache and blurred vision. Which action should the nurse take first?
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A patient with cystic fibrosis is admitted with a respiratory infection. Which combination of interventions should the nurse prioritize?
A patient with cystic fibrosis is admitted with a respiratory infection. Which combination of interventions should the nurse prioritize?
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A patient with atrial fibrillation is started on digoxin. Which assessment finding would indicate digoxin toxicity?
A patient with atrial fibrillation is started on digoxin. Which assessment finding would indicate digoxin toxicity?
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A patient with Addison's disease is admitted with an acute adrenal crisis. Which intervention should the nurse implement first?
A patient with Addison's disease is admitted with an acute adrenal crisis. Which intervention should the nurse implement first?
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A patient with diabetic ketoacidosis is receiving IV insulin and fluids. Which laboratory value should the nurse monitor most closely?
A patient with diabetic ketoacidosis is receiving IV insulin and fluids. Which laboratory value should the nurse monitor most closely?
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A patient with glomerulonephritis is prescribed prednisone. Which instruction is most important for the nurse to provide?
A patient with glomerulonephritis is prescribed prednisone. Which instruction is most important for the nurse to provide?
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A patient with a subdural hematoma is receiving mannitol. Which assessment finding would indicate the medication is effective?
A patient with a subdural hematoma is receiving mannitol. Which assessment finding would indicate the medication is effective?
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A patient with COPD is using a metered-dose inhaler (MDI) incorrectly. After teaching proper technique, which action by the nurse best evaluates the effectiveness of the education?
A patient with COPD is using a metered-dose inhaler (MDI) incorrectly. After teaching proper technique, which action by the nurse best evaluates the effectiveness of the education?
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A patient with heart failure is prescribed spironolactone. Which laboratory value should the nurse monitor most closely?
A patient with heart failure is prescribed spironolactone. Which laboratory value should the nurse monitor most closely?
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A patient with COPD is receiving oxygen therapy at 4 L a minute via nasal cannula. Which assessment finding would indicate the need to adjust the oxygen flow rate?
A patient with COPD is receiving oxygen therapy at 4 L a minute via nasal cannula. Which assessment finding would indicate the need to adjust the oxygen flow rate?
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Study Notes
COPD and Inhaler Technique
- Evaluating education effectiveness involves observing the patient’s correct use of the metered-dose inhaler (MDI).
Heart Failure Management
- New onset of peripheral edema, weight gain, and dyspnea in heart failure patients requires interventions like diuretics, fluid restriction, and monitoring weight.
Metabolic Syndrome Adherence
- Long-term adherence strategies include personalized lifestyle changes with continuous support and motivation.
Chronic Kidney Disease and Potassium Levels
- In patients with a potassium level of 6.5 mEq/L, anticipate interventions like dietary potassium restriction and possible administration of calcium gluconate.
Stroke Intervention
- For sudden right-sided weakness and aphasia post-stroke, prioritizing a rapid assessment and notifying a provider is critical.
Asthma Treatment
- Prepare to administer bronchodilators first in cases of severe wheezing and respiratory distress.
Pneumonia Care
- Effective management for difficulty in clearing secretions includes hydration, chest physiotherapy, and expectorants.
Beta-Blocker Side Effects
- Dizziness and fatigue in patients on beta-blockers can signal hypotension, necessitating immediate assessment.
Hypothyroidism Management
- A TSH level of 12 mIU/L despite therapy could be due to inadequate dosing or poor absorption of the medication.
Dietary Recommendations for CKD
- For a GFR of 25 mL/min, recommend low-protein, low-sodium, and low-potassium diet adjustments.
Epilepsy Seizure Protocol
- During a tonic-clonic seizure lasting 6 minutes, ensure the patient's safety, administer oxygen if necessary, and monitor vital signs.
Tuberculosis Compliance
- Improve medication adherence in tuberculosis patients through directly observed therapy (DOT).
Chest Pain Prioritization
- Chest pain with diaphoresis and ST-segment elevation requires immediate administration of antithrombotics and monitoring.
Diabetes Perioperative Plan
- Pre-surgery management for type 1 diabetes involves insulin adjustment and glucose monitoring.
Acute Renal Failure Interventions
- Anticipated actions include fluid management, monitoring electrolytes, and possible renal replacement therapy.
Cushing's Syndrome Education
- Important preoperative education includes the understanding of potential for adrenal crisis post-surgery.
Autonomic Dysreflexia Response
- First response includes sitting the patient upright and relieving any identified triggers.
Cystic Fibrosis Interventions
- Mobilizing secretions in cystic fibrosis patients involves chest physiotherapy, hydration, and bronchodilators.
Atrial Fibrillation Management
- Anticipated interventions may include anticoagulation therapy and rate control.
Diabetic Ketoacidosis Management
- Prioritize fluid resuscitation, insulin therapy, and electrolyte monitoring with a focus on potassium.
Addison's Disease Interventions
- For weakness, hypotension, and electrolyte imbalances, immediate administration of IV fluids and steroids is critical.
Glomerulonephritis Management
- Implement monitoring of vital signs, fluid balance, and administering medications as prescribed.
Subdural Hematoma Protocol
- Prioritize neurological assessments and prepare for potential surgical intervention.
COPD Exacerbation Management
- Address acute exacerbations with bronchodilators, systemic corticosteroids, and oxygen therapy.
Heart Failure Pulmonary Edema Response
- Interventions include diuretics, oxygen therapy, and positioning the patient for comfort.
Diabetes Treatment Adjustment
- In response to fasting blood glucose of 180 mg/dL, consider adding or adjusting medication types, including insulin.
Thyroid Storm Interventions
- Critical interventions involve beta-blockers, corticosteroids, and strict monitoring of vital signs.
Polycystic Kidney Disease Diagnostics
- First diagnostic test to prepare for is an abdominal ultrasound to assess kidney structure.
ICP and CPP Management
- In cases of increased ICP, interventions may include elevating the head of the bed and administering hypertonic saline.
Acid-Base Homeostasis
- In patients with emphysema and respiratory acidosis, assist with increasing ventilation support.
Warfarin Patient Education
- Key educational points include managing dietary vitamin K intake and monitoring for signs of bleeding.
DKA Protocol Modification
- For potassium levels at 2.8 mEq/L, modify the DKA protocol to include potassium replacement.
Hypothyroidism Assessment Focus
- Assess absorption issues or possible non-compliance as reasons for fatigue and weight gain despite therapy.
Dialysis Decision Factors
- Key factors include the patient’s lifestyle, preferences, and long-term prognosis.
Autonomic Dysreflexia First Action
- First implement measures to relieve bladder distension or bowel impaction.
Tuberculosis Medication Monitoring
- Closely monitor liver function tests, particularly during isoniazid therapy.
Unstable Angina Next Steps
- Prepare to administer intravenous nitroglycerin for chest pain unrelieved by sublingual medication.
Insulin Regimen Adjustment
- For recurrent hypoglycemia, a reduction in insulin dose or adjustment of carbohydrate intake is advisable.
Cushing’s Postoperative Complications
- Monitor patients for adrenal insufficiency or infection post-adrenalectomy.
Severe Headache and Vision Issues
- Undertake a thorough blood pressure check and assess for potential increasing intracranial pressure.
Cystic Fibrosis Respiratory Infection Management
- Prioritized interventions include IV antibiotics, chest physiotherapy, and maintaining airway patency.
Digoxin Toxicity Indicators
- Look for symptoms like changes in heart rate or rhythm, such as bradycardia.
Acute Adrenal Crisis Response
- First, administer IV hydrocortisone or equivalent steroid therapy.
DKA Monitoring Focus
- Closely monitor blood glucose levels and electrolytes during IV insulin treatment.
Prednisone Instruction
- Emphasize the importance of taking medication as prescribed and monitoring for infection risk.
Mannitol Effectiveness Assessment
- Evaluate neurological status and reduction in ICP as indicators of mannitol efficacy.
COPD Oxygen Therapy Assessment
- Adjust oxygen flow rate if the patient exhibits signs of hypoxemia or hypercapnia.
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