The nurse in a medical unit is caring for a patient with heart failure. The patient suddenly develops extreme dyspnea, tachycardia, and lung crackles. The nurse immediately asks another nurse to contact the primary health care provider and prepares to implement which priority interventions? Select all that apply.

A patient with a history of type 2 diabetes is admitted to the hospital with chest pain. The client is scheduled for a cardiac catheterization. Which medication would need to be withheld for 24 hours before the procedure and for 48 hours after the procedure?

The nurse notes that a patient with sinus rhythm has a premature ventricular

contraction that falls on the T wave of the preceding beat. The patient's rhythm suddenly changes to one with no P waves, no definable QRS complexes, and coarse wavy lines of varying amplitude. How should the nurse interpret this rhythm?

A patient with myocardial infarction is developing cardiogenic shock. What condition should the nurse carefully assess the client for?

The nurse is caring for a patient who had a resection of an abdominal aortic aneurysm yesterday. The client has an intravenous (IV) infusion at a rate of 150 mL/hr, unchanged for the last 10 hours. The patient’s urine output for the last 3 hours has been 90, 50, and 28 mL (28 mL is most recent). The client’s blood urea nitrogen level is 35 mg/dL (12.6 mmol/L), and the serum creatinine level is 1.8 mg/dL (159 mcmol/L), measured this morning. Which

nursing action is the priority?

The nurse is assessing the neurovascular status of a patient who returned to the surgical nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable. How should the nurse interpret the client’s neurovascular status?

The nurse is evaluating the condition of a patient after pericardiocentesis performed to treat cardiac tamponade. Which observation would indicate that the procedure was effective?

The nurse reviews the arterial blood gas results of a patient and notes the following:pH7.45,Paco2of30mmHg(30mmHg),andHCO3– of20mEq/L (20 mmol/L). The nurse analyzes these results as indicating which condition?

The nurse is caring for a patient with diabetic ketoacidosis and documents that the client is experiencing Kussmaul’s respirations. Which patterns did the nurse observe? Select all that apply.

A patient with a 3-day history of nausea and vomiting presents to the emergency department. The patient is hypoventilating and has a respiratory rate of 10 breaths per minute. The electrocardiogram (ECG) monitor displays tachycardia, with a heart rate of 120 beats per minute. Arterial blood gases are drawn and the nurse reviews the results, expecting to note which finding?

The emergency department nurse is assessing a patient who has sustained a blunt injury to the chest wall. Which finding indicates the presence of a pneumothorax in this client?

The nurse performs an admission assessment on a patient with a diagnosis of tuberculosis. The nurse should check the results of which diagnostic test that will confirm this diagnosis?

The nurse is caring for a patient hospitalized with acute exacerbation of chronic obstructive pulmonary disease. Which findings would the nurse expect to note on assessment of this patient? Select all that apply.

The nurse is instructing a hospitalized patient with a diagnosis of emphysema about measures that will enhance the effectiveness of breathing during dyspneic periods. Which position should the nurse instruct the client to assume?

A patient arrives at the emergency department with complaints of low

abdominal pain and hematuria. The patient is afebrile. The nurse next assesses the patient to determine a history of which condition?

The nurse is instructing a patient with diabetes mellitus about peritoneal dialysis. The nurse tells the patient that it is important to maintain the prescribed dwell time for the dialysis because of the risk of which complication?

The nurse is assessing the patency of a patient’s left arm arteriovenous fistula

prior to initiating hemodialysis. Which finding indicates that the fistula is patent?

The nurse is reviewing a patient’s record and notes that the primary health care provider has documented that the client has chronic kidney disease. On review of the laboratory results, the nurse most likely would expect to note which finding?

A patient with severe back pain and hematuria is found to have hydronephrosis due to urolithiasis. The nurse anticipates which treatment will be done to relieve the obstruction? Select all that apply.

A patient with a diagnosis of diabetic ketoacidosis (DKA) is being treated in 1423

the emergency department. Which findings support this diagnosis? Select all that apply.

The nurse provides instructions to a patient newly diagnosed with type 1

diabetes mellitus. The nurse recognizes accurate understanding of measures to prevent diabetic ketoacidosis when the patient makes which statement?

A patient has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this patient?

A patient is brought to the emergency department in an unresponsive state, and a diagnosis of hyperosmolar hyperglycemic syndrome is made. The nurse would immediately prepare to initiate which anticipated primary health care provider’s prescription?

A patient has been diagnosed with hyperthyroidism. The nurse monitors for which signs and symptoms indicating a complication of this disorder? Select all that apply.

The nurse is reviewing the laboratory results of a patient diagnosed with multiple myeloma. Which would the nurse expect to note specifically in this disorder?

A patient is admitted to the hospital with a suspected diagnosis of Hodgkin’s disease. Which assessment finding would the nurse expect to note specifically in the patient?

Laboratory studies are performed for a patient suspected to have iron deficiency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia?

A patient with carcinoma of the lung develops syndrome of inappropriate

antidiuretic hormone (SIADH) as a complication of the cancer. The nurse anticipates that the primary health care provider will request which prescriptions? Select all that apply.

As part of chemotherapy education, the nurse teaches a female patient about the risk for bleeding and self-care during the period of greatest bone marrow suppression (the nadir). The nurse understands that further teaching is needed if the patient makes which statement?