When a patient with acute kidney injury (AKI) has an arterial blood pH of 7.30, the nurse will expect an assessment finding of

The nurse is planning care for a patient with severe heart failure who has developed elevated blood urea nitrogen (BUN) and creatinine levels. The primary treatment goal in the plan will be

A patient who has acute glomerulonephritis is hospitalized with hyperkalemia. Which information will the nurse monitor to evaluate the effectiveness of the prescribed calcium gluconate IV?

Which statement by a patient with stage 5 chronic kidney disease (CKD) indicates that the nurse’s teaching about management of CKD has been effective?

Sodium polystyrene sulfonate (Kayexalate) is ordered for a patient with hyperkalemia. Before administering the medication, the nurse should assess the

Which menu choice by the patient who is receiving hemodialysis indicates that the nurse’s teaching has been successful?

Before administration of calcium carbonate to a patient with chronic kidney disease (CKD), the nurse should check laboratory results for

A 37-yr-old female patient is hospitalized with acute kidney injury (AKI). Which information will be most useful to the nurse in evaluating improvement in kidney function?

A patient will need vascular access for hemodialysis. Which statement by the nurse accurately describes an advantage of a fistula over a graft?

When caring for a patient with a left arm arteriovenous fistula, which action will the nurse include in the plan of care to maintain the patency of the fistula?

A patient who has had progressive chronic kidney disease (CKD) for several years has just begun regular hemodialysis. Which information about diet will the nurse include in patient teaching?

Which information in a patient’s history indicates to the nurse that the patient is not an appropriate candidate for kidney transplantation?

Which assessment finding may indicate that a patient is experiencing adverse effects to a corticosteroid prescribed after kidney transplantation?

The nurse in the dialysis clinic is reviewing the home medications of a patient with chronic kidney disease (CKD). Which medication reported by the patient indicates that patient teaching is required?

Before administration of captopril to a patient with stage 2 chronic kidney disease (CKD), the nurse will check the patient’s

A patient with diabetes who has bacterial pneumonia is being treated with IV gentamicin 60 mg IV BID. The nurse will monitor for adverse effects of the medication by evaluating the patient’s

A 55-yr-old patient with end-stage kidney disease (ESKD) is scheduled to receive a prescribed dose of epoetin alfa (Procrit). Which information should the nurse report to the health care provider before giving the medication?

A 25-yr-old male patient has been admitted with a severe crushing injury after an industrial accident. Which laboratory result will be most important to report to the health care provider?

A 62-yr-old female patient has been hospitalized for 4 days with acute kidney injury (AKI) caused by dehydration. Which information will be most important for the nurse to report to the health care provider?

A patient with acute kidney injury (AKI) has longer QRS intervals on the electrocardiogram (ECG) than were noted on the previous shift. Which action should the nurse take first?

A 42-yr-old patient admitted with acute kidney injury due to dehydration has oliguria, anemia, and hyperkalemia. Which prescribed action should the nurse take first?

During routine hemodialysis, a patient complains of nausea and dizziness. Which action should the nurse take first?

After receiving change-of-shift report, which patient should the nurse assess first?

Which information will be included when the nurse is teaching self-management to a patient who is receiving peritoneal dialysis (select all that apply)?

A client is at high risk for developing ascites because of cirrhosis of the liver. How should the nurse assess for the presence of ascites?

A client is admitted to the hospital for acute gastritis and ascites secondary to alcoholism and cirrhosis. For which condition is it most important for the nurse to assess this client?

What will the nurse do to assess a client's response to ongoing serum albumin therapy for cirrhosis of the liver?

The nurse is administering lactulose to a client with a history of cirrhosis of the liver. The client asks the nurse why this medication is needed because the client is not constipated. How will the nurse respond?

A client with cirrhosis of the liver develops ascites, and the health care provider prescribes spironolactone. What should the nurse monitor the client for?

Neomycin is prescribed for a client with cirrhosis. What should the nurse explain is the reason for taking this medication?

A nurse administers lactulose to a client with cirrhosis of the liver. Which laboratory test change leads the nurse to determine that the lactulose is effective?

A client is diagnosed with acute gastritis secondary to alcoholism and cirrhosis. The client reports frequent nausea, pain that increases after meals, and black, tarry stools. The client recently joined Alcoholics Anonymous. The nurse should give priority to which client history item?

The nurse is assessing a client with severe cirrhosis and discovers fetor hepaticus. What did the nurse assess?

A client with hepatic cirrhosis begins to develop slurred speech, confusion, drowsiness, and a flapping tremor. Which diet can the nurse expect will be prescribed for this client based upon the assessment?

A client with a long history of alcohol abuse is admitted to the hospital with ascites and jaundice. A diagnosis of hepatic cirrhosis is made. Which is a nursing priority?

The serum ammonia level of a client with hepatic cirrhosis and ascites is elevated. What nursing intervention is the priority?

A nurse is caring for a client with cirrhosis of the liver. Which laboratory test should the nurse monitor that, when abnormal, might identify a client who may benefit from neomycin enemas?

A client with cirrhosis is scheduled for a liver biopsy. The client asks if there are any risks after the procedure. Which response by the nurse is the best?

A client with hepatitis B (HBV) develops cirrhosis and is hospitalized. One potential sequela of chronic liver disease is fluid and electrolyte imbalance. The nurse determines that this may be attributed to a decrease in serum albumin level. Which of these conditions results from this imbalance?

A client with cirrhosis of the liver and ascites is scheduled to have a paracentesis. What should the nurse do to prepare the client for the procedure?

A client with a history of alcoholism and cirrhosis is admitted with severe dyspnea as a result of ascites. Which process that most likely caused the ascites should the nurse consider when planning care?

A nurse is performing the physical assessment of a client admitted to the hospital with a diagnosis of cirrhosis. The nurse expects to observe what skin conditions? Select all that apply.

A client is admitted to the hospital with a diagnosis of cirrhosis of the liver. For which assessment signs of hepatic encephalopathy should the nurse assess this client? Select all that apply.

A nurse is providing discharge instructions to a client diagnosed with cirrhosis and varices. Which information should the nurse include in the teaching session? Select all that apply.

You are caring for a patient in the emergency room who does not give a past medical history but presents with a one-week history of shortness of breath. An arterial blood gas is obtained, and the results are as follows: The pH is 7.31, the PaCO2 is 72 mm Hg, and the bicarbonate is 35 mEq/L. What does the blood gas show?

You are caring for a patient who presents with a two-day history of diarrhea. An arterial blood gas is obtained, revealing a pH of 7.25, a PaCO2 of 24 mm Hg, and a bicarbonate of 10 mEq/L. What does the blood gas tell you in this situation?

The patient is a 21-year-old male with a depressed mental status in the emergency department for reasons that are not completely clear. An arterial blood gas is obtained with a pH of 7.26, PaCO2 of 70 mm Hg, and a bicarbonate of 31 mEq/L. What does the arterial blood gas tell you about this patient?

The patient is a 13-year-old female with a depressed mental status and abdominal pain. She does not have a significant past medical history. Her ABG is drawn, showing a pH of 7.14, a PaCO2 of 15 mm Hg, and a bicarbonate of 5 mEq/L. What does the arterial blood gas tell you about this patient?

You are caring for a figure skater who presents with weakness and no other past medical history. An arterial blood gas is obtained showing a pH of 7.54, a PaCO2 of 45, and a bicarbonate of 38. Electrolytes are obtained showing sodium is 140, potassium is 2.8, and chloride is 95. What do the patient's laboratory studies say about her?

The patient is an 80-year-old man who has a history of congestive heart failure. He says he has been sick for about a week and has been vomiting. He has been short of breath for several days. His arterial blood gas shows a pH of 7.54, a PaCO2 of 21, and a bicarbonate of 19 mEq/L. What does the patient’s arterial blood gas say about him?

You are caring for an older woman from a nursing home who presents with weakness. She has been taking a sleeping pill but takes no other medications. An arterial blood gas is drawn, showing a pH of 7.58, a PaCO2 of 53, and a bicarbonate of 44 mEq/L. What does the arterial blood gas reveal about her?

The patient is a 32-year-old female with a history of asthma. She checks into the emergency department stating she is short of breath. An arterial blood gas is obtained on room air showing a pH of 7.3, PaCO2 of 46 mm Hg, bicarbonate of 24 mEq/L, and a PaO2 of 56. What does the patient’s blood gas say about her?

The patient is a 3-day old infant who is not interested in feeding and has a rapid respiratory rate. An arterial blood gas is obtained on the baby, revealing a pH of 7.53, a PaO2 of 103 mm Hg. A PaCO2 of 27 mm Hg, and a bicarbonate of 24 mEq/L. What does the baby’s arterial blood gas say about her?

The infant is a newborn with tachypnea and cyanosis. An arterial blood gas is obtained on room air, showing a pH of 7.1, a PaCO2 of 40 mm Hg, and a bicarbonate of 12 mEq/L. The PaO2 is 60 mm Hg. What does the blood gas say about this infant?

Which intervention will be included in the plan of care for a patient with acute kidney injury (AKI) who has a temporary vascular access catheter in the left femoral vein?

A 25-yr-old male patient has been admitted with a severe crushing injury after an industrial accident. Which laboratory result will be most important to report to the health care provider?

A 72-yr-old patient with a history of benign prostatic hyperplasia (BPH) is admitted with acute urinary retention and elevated blood urea nitrogen (BUN) and creatinine levels. Which prescribed therapy should the nurse implement first?

A 62-yr-old female patient has been hospitalized for 4 days with acute kidney injury (AKI) caused by dehydration. Which information will be most important for the nurse to report to the health care provider?

A patient with acute kidney injury (AKI) has longer QRS intervals on the electrocardiogram (ECG) than were noted on the previous shift. Which action should the nurse take first?

A 42-yr-old patient admitted with acute kidney injury due to dehydration has oliguria, anemia, and hyperkalemia. Which prescribed action should the nurse take first?

A patient has arrived for a scheduled hemodialysis session. Which nursing action is most appropriate for the registered nurse (RN) to delegate to a dialysis technician?

A licensed practical/vocational nurse (LPN/LVN) is caring for a patient with stage 2 chronic kidney disease. Which observation by the RN requires an intervention?

A female patient with chronic kidney disease (CKD) is receiving peritoneal dialysis with 2-L inflows. Which information should the nurse report promptly to the health care provider?

The nurse is assessing a patient 4 hours after a kidney transplant. Which information is most important to communicate to the health care provider?

The nurse is caring for a patient who has cirrhosis. Which data obtained by the nurse during the assessment will be of most concern?

A patient with cirrhosis and esophageal varices has a new prescription for propranolol (Inderal). Which finding is the best indicator to the nurse that the medication has been effective?

Which response by the nurse best explains the purpose of ranitidine (Zantac) for a patient admitted with bleeding esophageal varices?

When taking the blood pressure (BP) on the right arm of a patient with severe acute pancreatitis, the nurse notices carpal spasms of the patient’s right hand. Which action should the nurse take next?

A patient with acute pancreatitis is NPO and has a nasogastric (NG) tube to suction. Which information obtained by the nurse indicates that these therapies have been effective?

Which assessment finding is of most concern for a patient with acute pancreatitis?

Which action will be included in the care for a patient who has recently been diagnosed with asymptomatic nonalcoholic fatty liver disease (NAFLD)?

A patient with chronic hepatitis C infection has several medications prescribed. Which medication requires further discussion with the health care provider before administration?

During change-of-shift report, the nurse learns about the following four patients. Which patient requires assessment first?

Which goal has the highest priority in the plan of care for a 26-yr-old patient who is homeless who was admitted with viral hepatitis who has severe anorexia and fatigue?

Which action should the nurse in the emergency department take first for a new patient who is vomiting blood?

The nurse is planning care for a patient with acute severe pancreatitis. The highest priority patient outcome is

The nurse is caring for a patient with pancreatic cancer. Which nursing action is the highest priority?

Which assessment information will be most important for the nurse to report to the health care provider about a patient with acute cholecystitis?

A patient had an incisional cholecystectomy 6 hours ago. The nurse will place the highest priority on assisting the patient to

Which action will the nurse include in the plan of care for a patient who has been diagnosed with chronic hepatitis B?

A patient born in 1955 had hepatitis A infection 1 year ago. According to Centers for Disease Control and Prevention (CDC) guidelines, which action should the nurse include in care when the patient is seen for a routine annual physical examination?

A 36-yr-old female patient is receiving treatment for chronic hepatitis C with pegylated interferon (PEG-Intron, Pegasys), ribavirin (Rebetol), and telaprevir (Incivek). Which finding is important to communicate to the health care provider to suggest a change in therapy?

A patient with septicemia develops prolonged bleeding from venipuncture sites and blood in the stools. Which action is most important for the nurse to take?

A patient with possible disseminated intravascular coagulation arrives in the emergency department with a blood pressure of 82/40, temperature of 102° F (38.9° C), and severe back pain. Which prescribed action will the nurse implement first?

The nurse determines that demeclocycline is effective for a patient with syndrome of inappropriate antidiuretic hormone (SIADH) based on finding that the patient’s

The nurse determines that additional instruction is needed for a patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH) when the patient makes which statement?

A 56-yr-old patient who is disoriented and reports a headache and muscle cramps is hospitalized with possible syndrome of inappropriate antidiuretic hormone (SIADH). The nurse would expect the initial laboratory results to include a(n)

An expected patient problem for a patient admitted to the hospital with symptoms of diabetes insipidus is 

The nurse is caring for a woman recently diagnosed with viral hepatitis A. Which individual should the nurse refer for an immunoglobulin (IG) injection? 

The nurse is caring for a 55-yr-old man patient with acute pancreatitis resulting from gallstones. Which clinical manifestation would the nurse expect?

The nurse is caring for a woman recently diagnosed with viral hepatitis A. Which individual should the nurse refer for an immunoglobulin (IG) injection?

The nurse instructs a 50-yr-old woman about cholestyramine to reduce pruritus caused by gallbladder disease. Which patient statement indicates understanding of the instructions?

The family of a patient newly diagnosed with hepatitis A asks the nurse what they can do to prevent becoming ill. Which response by the nurse is most appropriate?

A patient with hepatitis B surface antigen (HBsAg) present in the serum is being discharged with pain medication after knee surgery. Which medication order should the nurse question?

The condition of a patient who has cirrhosis of the liver has deteriorated. Which diagnostic study would help determine if the patient has developed liver cancer?

The patient with right upper quadrant abdominal pain has an abdominal ultrasound that reveals cholelithiasis. What is the nurse’s priority?

A patient with cholelithiasis is being prepared for surgery. Which patient assessment represents a contraindication for a cholecystectomy?

The patient with cirrhosis is being taught self-care. Which statement indicates the patient needs more teaching?

A patient with sudden pain in the left upper quadrant radiating to the back and vomiting was diagnosed with acute pancreatitis. Which intervention should the nurse include in the patient’s plan of care?

Diffusion, osmosis, and ultrafiltration occur in both hemodialysis and peritoneal dialysis. Which strategy is used to achieve ultrafiltration in peritoneal dialysis?

During hemodialysis, the patient develops light-headedness and nausea. What should the nurse do first?

Which findings will the nurse expect when caring for a patient with chronic kidney disease (CKD) (select all that apply.)?

Which assessment findings would alert the nurse that the patient has entered the diuretic phase of acute kidney injury (AKI) (select all that apply.)?

For the strip above, what is the HR?

For the strip, what is the EKG rhythm?

For the above strip, what is the HR?

For the above strip, what is the EKG rhythm? 

For the above strip, what is the HR? 

For the above strip, what is the EKG rhythm? 

For the above strip, what is the HR? 

For the above strip, what is the EKG rhythm? 

For the above strip, what is the HR? 

For the above strip, what is the EKG rhythm? 

For the above strip, what is the EKG rhythm? 

For the above strip, what is the EKG rhythm? 

For the above strip, what is the HR? 

For the above strip, what is the EKG rhythm? 

For the above strip, what is the HR? 

For the above strip, what is the EKG rhythm? 

For the above strip, what is the EKG rhythm? 

For the above strip, what is the EKG rhythm? 

For the above strip, what is the EKG rhythm? 

For the above strip, what is the EKG rhythm? 

While auscultating the heart, a healthcare provider notices S3 heart sounds in four clients. Which client is at more risk for heart failure? 

Which serum laboratory values in a client with urinary problems may indicate the risk of developing muscle weakness and cardiac arrhythmias? 

A client with hypertensive heart disease, who had an acute episode of heart failure, is to be discharged on a regimen of metoprolol and digoxin. What outcome does the nurse anticipate when metoprolol is administered with digoxin? 

A client with a history of cirrhosis of the liver develops heart failure. When ventricular bigeminy develops, the provider orders lidocaine. What alterations in lidocaine dosages does the nurse anticipate? 

A client with heart failure is digitalized (given a loading dose of digoxin) and placed on a maintenance dose of digoxin 0.25 mg by mouth daily. What responses does the nurse expect the client to exhibit when a therapeutic effect of digoxin is achieved? 

A client is taking furosemide and digoxin for heart failure. Why does the nurse advise the client to drink a glass of orange juice every day? 

A client who develops heart failure has a serum potassium level of 2.3 mEq/L (2.3 mmol/L). Digoxin and potassium chloride are prescribed. What action should the nurse take? 

When an older client with heart failure is transferred from the emergency department to the medical service, what should the nurse on the unit do first? 

To manage heart failure a client has been taking several medications, including furosemide 40 mg by mouth twice a day. The client develops severe muscle cramps and fatigue, and laboratory tests confirm the presence of hypokalemia. Potassium chloride intravenously (IV) and ECG monitoring have been prescribed. Which ECG change associated with hypokalemia should the nurse expect to observe? 

An older client who has had multiple hospital admissions for recurring heart failure is returned to the hospital by an adult child. The client is admitted for observation to the coronary care unit and calmly states, "I know I’m sick, but I can really take care of myself at home." What should the nurse conclude that the client most likely is attempting to do? 

A nurse expects that a client with right-sided heart failure will exhibit which of these signs or symptoms? 

The family of a client with right ventricular heart failure expresses concern about the client’s increasing abdominal girth. What physiologic change should the nurse consider when explaining the client’s condition? 

How can the nurse best describe heart failure to a client? 

The nurse is assessing a client with the diagnosis of chronic heart failure. Which clinical finding should the nurse expect the client to experience? 

A nurse is obtaining a health history on a client admitted to the hospital with heart failure. Which assessment finding will the nurse expect the client to report? 

The nurse is caring for a client who is admitted to the hospital with early heart failure. Which client statement indicates a clinical manifestation that is related to heart failure? 

The nurse is caring for a client who is admitted with the diagnosis of mild heart failure. Which type of lung sounds should the nurse expect to hear? 

A client with heart failure has anxiety. Which effect of anxiety makes it particularly important for the nurse to reduce the anxiety of this client? 

A client with a history of heart failure is experiencing dyspnea with a respiratory rate of 32. Crackles are noted bilaterally. The client is in Sims position, receiving oxygen at 2 L/min via nasal cannula. Which action should the nurse take first? 

A client with congestive heart failure is receiving intravenous digoxin (Cardoxin) therapy. The registered nurse identifies that which items on the client’s care plan are appropriate for a licensed practical nurse (LPN) to perform? Select all that apply. 

To determine whether there is a delay in impulse conduction through the ventricles, the nurse will measure the duration of the patient’s

The nurse needs to quickly estimate the heart rate for a patient with a regular heart rhythm. Which method will be best to use?

A patient has a junctional escape rhythm on the monitor. The nurse will expect the patient to have a heart rate of _____ beats/min.

What rhythm is this?

The nurse notes that a patient’s heart monitor shows that every other beat is earlier than expected, has no visible P wave, and has a QRS complex that is wide and bizarre in shape. How will the nurse document the rhythm?

A patient has a sinus rhythm and a heart rate of 72 beats/min. The nurse determines that the PR interval is 0.24 seconds. The most appropriate intervention by the nurse would be to

A patient who was admitted with a myocardial infarction experiences a 45-second episode of ventricular tachycardia, then converts to sinus rhythm with a heart rate of 98 beats/min. Which action should the nurse take next?

After the nurse gives IV atropine to a patient with symptomatic type 1, second-degree atrioventricular (AV) block, which finding indicates that the drug has been effective?

A patient with dilated cardiomyopathy has new onset atrial fibrillation that has been unresponsive to drug therapy for several days. Teaching for this patient would include information about

Which information will the nurse include when teaching a patient who is scheduled for a radiofrequency catheter ablation for treatment of atrial flutter?

The nurse knows that discharge teaching about the management of a new permanent pacemaker has been most effective when the patient states

Which intervention by a new nurse who is caring for a patient who has just had an implantable cardioverter-defibrillator (ICD) inserted indicates a need for more teaching about the care of patients with ICDs?

Which action should the nurse perform when preparing a patient with supraventricular tachycardia for cardioversion who is alert and has a blood pressure of 110/66 mm Hg?

A 20-yr-old patient has a mandatory electrocardiogram (ECG) before participating on a college soccer team and is found to have sinus bradycardia, rate 52. Blood pressure (BP) is 114/54 mm Hg, and the student denies any health problems. What action by the nurse is most appropriate?

When analyzing the rhythm of a patient’s electrocardiogram (ECG), the nurse will need to investigate further upon finding a(n)

A patient has ST segment changes that suggest an acute inferior wall myocardial infarction. Which lead would be best for monitoring the patient?

Which laboratory result for a patient with multifocal premature ventricular contractions (PVCs) is most important for the nurse to communicate to the health care provider?

A patient’s heart monitor shows a pattern of undulations of varying contours and amplitude with no measurable ECG pattern. The patient is unconscious, apneic, and pulseless. Which action should the nurse take first?

A patient’s heart monitor shows sinus rhythm, rate 64. The PR interval is 0.18 seconds at 1:00 AM, 0.22 seconds at 2:30 PM, and 0.28 seconds at 4:00 PM. Which action should the nurse take next?

A patient develops sinus bradycardia at a rate of 32 beats/min, has a blood pressure (BP) of 80/42 mm Hg, and is complaining of feeling faint. Which action should the nurse take next?

A 19-yr-old student comes to the student health center at the end of the semester complaining that, “My heart is skipping beats.” An electrocardiogram (ECG) shows occasional unifocal premature ventricular contractions (PVCs). What action should the nurse take next?

The nurse has received change-of-shift report about the following patients on the progressive care unit. Which patient should the nurse see first

A patient who is on the telemetry unit develops atrial flutter, rate 150, with associated dyspnea and chest pain. Which action that is included in the hospital dysrhythmia protocol should the nurse do first?

A patient whose heart monitor shows sinus tachycardia, rate 132, is apneic, and has no palpable pulses. What action should the nurse take next?

Which action will the nurse include in the plan of care for a patient who was admitted with syncopal episodes of unknown origin?

Which nursing action can the registered nurse (RN) delegate to experienced unlicensed assistive personnel (UAP) working as telemetry technicians on the cardiac care unit?

Which action by a new registered nurse (RN) who is orienting to the telemetry unit indicates a good understanding of the treatment of heart dysrhythmias?

A patient reports dizziness and shortness of breath for several days. During heart monitoring in the emergency department (ED), the nurse obtains the following electrocardiographic (ECG) tracing. The nurse interprets this heart rhythm as

What rhythm is this?