WorksheetsWorkbook Quiz Ch. 3 and 4
Total questions: 60
Worksheet time: 31mins
When scheduling a patient for skin testing for allergies, which information is most important for the allergy clinic nurse to include in patient teaching
avoid taking antihistamines or antihistamine containing medications for 5 to 7 days before the skin testing
you may need to wear a patch for 48 hours in case of delayed reaction
swelling and itching may occur at the site of the skin testing
patient will need to wait in the clinic for 20 minutes after the testing
which finding will be most important for the nurse to report to the health care provider about a patient who is taking prednisone chronically after an organ transplant
multiple arm bruises
sodium level of 146 mEq/dL (146 mmol/L)
blood glucose of 110 mg/dL (6.1 mmol/L)
black-colored stools
when the occupational health nurse is teaching assistive personnel about bloodborne pathogen exposure and HIV risk, which information is most important to emphasize
occupational transmission of HIV from patients to healthcare workers is relatively rare
occupational exposure to HIV-containing fluids should be reported immediately to the supervisor
treatment for occupational exposure to HIV may include use of antiretroviral medications
postexposure treatment will include HIV testing at baseline and at several intervals after the exposure
a patient in the allergy clinic who has a rash has received diphenhydramine 50 mg PO. which patient information is most indicative of a need for action by the nurse
the patient is preparing to drive home
the patient reports itching at the site of the rash
the patient has a history of constipation
the patient states "my mouth feels so very dry"
after a change-of-shift report, which newly admitted patient should the nurse assess first
a patient with HIV whose CD4 count is 45 mm3 (45 cells/mcL)
a patient with acute kidney transplant rejection who has a scheduled dose of prednisone due
a patient with graft-versus-host disease who has frequent liquid stools
a patient with HTN who has angioedema after receiving lisinopril
a few minutes after the nurse has given an intradermal injection of an allergen to a patient who is undergoing skin testing for allergies, the patient reports feeling anxious, short of breath, and dizzy. which action included in the emergency protocol should the nurse take first
start oxygen at 6 L/min using a face mask
obtain IV access with a large-bore IV catheter
give epinephrine 0.5 mg intramuscularly
administer albuterol per nebulizer mask
the nurse manager in a public health department is implementing a plan to reduce the incidence of infection with HIV in the community. which nursing action will be delegated to assistive personnel (AP) working for the agency
supplying injection drug users with sterile injection equipment such as needles and syringes
interviewing patients about behaviors that indicate a need for annual HIV testing
teaching high-risk community members about the use of condoms in preventing HIV infection
assessing the community to determine which population groups to target for education
the nurse is supervising a student who is caring for a patient with HIV. the patient has severe esophagitis caused by candida albicans. which action by the student requires the most rapid intervention by the nurse
putting on a mask and gown before entering the patient's room
giving the patient a glass of water after administering the prescribed oral nystatin suspension
suggesting that the patient should order chili con carne or chicken soup for the next meal
placing a "no visitors" sign on the door of the patient's room
the nurse is evaluating a patient with HIV who is receiving trimethoprim-sulfamethoxazole (TMP-SMX) as a treatment for pneumocystis jiroveci pneumonia. which information is most important to communicate to the health care provider
the patient reports a blistering rash
the patient's fluid intake is 2 L/day
the patient's potassium is 3.4 mg/dL (3.4 mmol/L)
the patient enjoys spending time outside in the sun
a nursing student is helping the precepting nurse work through a preoperative checklist for a patient with rheumatoid arthritis who is scheduled to have an arthrodesis. the student asks the nurse what an arthrodesis is so she can explain the procedure and the risks to the patient before having the permit signed. what is the best response by the nurse
"a student nurse is not allowed to teach a patient without a preceptor present. we can do it together"
"this surgery involves removing the affected joint and fusing the adjacent bones together"
"don't worry about it; the surgeon will explain the procedure and all the potential risks"
"we'll discuss arthrodesis but the surgeon will explain the procedure and risks; we witness the patient's signature
a patient with newly diagnosed acquired immunodeficiency syndrome has a 6-mm induration at 48 hours after a skin test for TB. which action will the nurse anticipate taking next
arrange for a chest x-ray to check for active TB
tell the patient that the TB test results are negative
teach the patient about multidrug treatment for TB
schedule TB skin testing again in 12 months
the nurse is working in a hospice facility for patients with acquired immunodeficiency syndrome. the facility is staffed with LPNs/LVNs and assistive personnel (AP). Which action will the nurse assign to the LPN/LVN
assessing patients' nutritional needs and individualizing diet plans to improve nutrition
collecting data about the patients' responses to medications used for pain and anorexia
developing AP training programs about how to lower the risk for spreading infections
assisting patients with personal hygiene and other ADLs as needed
a patient who has received a kidney transplant has been admitted to the medical unit with acute rejection and is receiving IV cyclosporine and methylprednisolone. which staff member is best to assign to care for this patient
RN who floated to the medical unit from the coronary care unit for the day
RN with 3 years of experience in the OR who is orienting to the medical unit
RN who has worked on the medical unit for 5 years and is working a double shift today
newly graduated RN who needs experience with IV medication administration
the nurse is caring for a patient with rheumatoid arthritis who is taking naproxen twice a day to reduce inflammation and joint pain. which symptom is most important to communicate to the health care provider
joint pain worse in the morning
dry eyes bilaterally
round and moveable nodules under the skin
dark-colored stools
which of these patients cared for by the nurse in the clinic presents the highest risk for infection with HIV during sexual intercourse
uninfected man who reports performing oral intercourse with an HIV-infected woman
uninfected man who is the receiver during anal intercourse with an HIV-infected man
uninfected woman who has had vaginal intercourse with an HIV-infected man
uninfected woman who has performed oral intercourse with an HIV-infected woman
a patient with a history of liver transplantation is receiving cyclosporine, prednisone, and mycophenolate. which finding is of most concern
gums that appear very pink and swollen
blood glucose level of 162 mg/dL (9 mmol/L)
nontender lump above the clavicle
grade 1+ pitting edema in the feet and ankles
a patient with HIV who has been started on antiretroviral therapy is seen in the clinic for follow-up. which test will be best to monitor when determining the response to therapy
CD4 level
complete blood count
total lymphocyte percent
viral load
a hospitalized patient with acquired immunodeficiency syndrome has wasting syndrome. which nursing action is appropriate to assign to an LPN/LVN who is providing care to this patient
administering oxandrolone 5 mg/day
assessing the patient for other nutritional risk factors
developing a plan of care to improve the patient's appetite
providing instructions about a high-calorie, high-protein diet
the nurse assesses a 24 year old patient with rheumatoid arthritis who is considering using methotrexate for treatment. which patient information is most important to communicate to the health care provider
the patient has many concerns about the safety of the drug
the patient has been trying to get patient
the patient takes a daily multivitamin
the patient says that she has taken methotrexate in the past
an 18 year old college student with an exacerbation of systemic lupus erythematosus (SLE) has been receiving prednisone 20 mg/day for 4 days. which action prescribed by the health care provider is most important for the nurse to question
discontinue prednisone after today's dose
give a "catch-up" dose of varicella vaccine
check the patient's c-reactive protein level
administer ibuprofen 800 mg PO TID
a patient with wheezing and coughing caused by an allergic reaction is admitted to the ED. which medication will the nurse anticipate administering first
methylprednisolone 100 mg IV
cromolyn 20 mg via nebulizer
albuterol 2.5mg/4 mL via nebulizer
aminophylline 500 mg IV
a patient with systemic lupus erythematosus (SLE) is admitted to the hospital with acute joint inflammation. which information obtained in the laboratory testing will be of highest concern to the nurse
elevated blood urea nitrogen (BUN) level
increased c-reactive protein level
positive antinuclear antibody test result
positive lupus erythematosus cell preparation
the nurse obtains this information when assessing a patient with HIV who is taking antiretroviral therapy. which finding is most important to report to the health care provider
the blood glucose level is 144 mm/dL (8 mmol/L)
the hemoglobin level is 10.9 g/dL (109 g/L)
the patient reports frequent nausea
the patient's viral load has increased
initiation of subq etanercept for a patient with rheumatoid arthritis is being considered. which patient information is most important for the nurse to communicate with the health care provider
the patient is currently taking methotrexate
the patient has a positive TB skin test result
the patient has had type 2 diabetes for 5 years
the patient is anxious about having to self-inject
the hospital employee health nurse is completing a health history for a newly hired staff member. which information given by the new employee most indicates the need for further nursing action before the new employee begins orientation to patient care
the employee takes enalapril for HTN
the employee has allergies to bananas, avocados, and papayas
the employee received a tetanus vaccination 3 years ago
the employee's TB skin test has a 5-mm induration at 48 hours
a patient who has HIV and is taking nucleoside reverse transcriptase inhibitors and a protease inhibitor is admitted to the psychiatric unit with a panic attack. which information about the patient is most important to discuss with the health care provider
the patient exclaims, "I'm afraid I'm going to die right here"
the prescribed patient medications include midazolam 2 mg IV immediately
the patient is diaphoretic and tremulous and reports dizziness
the symptoms occurred suddenly while the patient was driving to work
a patient seen in the STD clinic has just tested positive for HIV with a rapid HIV test. which action will the nurse take next
ask about patient risk factors for HIV infection
send a blood specimen for western blot testing
provide information about antiretroviral therapy
discuss the positive test results with the patient
a patient diagnosed with systemic erythematosus lupus (SLE) is being seen in the clinic for a follow-up appointment. she is prescribed cyclosporin and indomethacin. which statement made by the patient should the nurse assess first
"my feet are swollen"
"I have a paper cut on my index finger and it's red and painful"
"it seems like I'm always so tired"
"I'm using a vitamin C cream to minimize the rash on my face"
the RN is admitting a patient with benign prostatic hyperplasia to an acute care unit. the patient describes an oral intake of about 1400 mL/day. what is the RNs priority concern
ask the patient about his bowel movements
have the patient complete a diet diary for the past 2 days
instruct the patient to increase oral intake to 2 to 3 L/day
ask the patient to describe his urine output
the patient has fluid volume deficit related to excessive fluid loss. which action related to fluid management should be delegated by the RN to the assistive personnel (AP)
administering IV fluids as prescribed by the health car provider
providing straws and offering fluids between meals
developing a plan for added fluid intake over 24 hours
teaching family members to assist the patient with fluid intake
the assistive personnel (AP) reports to the nurse that a patient's urine output for the past 24 hours has been only 360 mL. what is the nurse's priority action at this time
place an 18-gauge IV in the nondominant arm
elevate the patient's head of bed at least 45 degrees
instruct the AP to provide the patient with a pitcher of ice water
contact and notify the health care provider immediately
the patient is at risk for poor perfusion related to decreased plasma volume. which assessment finding supports this risk
flattened neck veins when the patient is in the supine position
full and bounding pedal and post-tibial pulses
pitting edema located in the feet, ankles, and calves
shallow respirations with crackles on auscultation
the nursing plan of care for an older patient with dehydration includes interventions for oral health. which interventions are within the scope of practice for an LPN/LVN being supervised by an RN? select all that apply
reminding the patient to avoid commercial mouthwashes
encouraging mouth rinsing with warm saline
assessing skin turgor by pinching the skin over the back of the hand
observing the lips, tongue, and mucous membranes
providing mouth care every 2 hours while the patient is awake
the health care provider has written these orders for a patient with a diagnosis of pulmonary edema. the patient's morning assessment reveals bounding peripheral pulses, a weight gain of 2 lb, pitting ankle edema, and moist crackles bilaterally. which order takes priority at this time
weigh the patient every morning
maintain accurate intake and output records
restrict fluids to 1500 mL/day
administer furosemide 40 mg IV push
which statement related to dehydration made by a patient with hypovolemia is the best indicator to the nurse of the need for additional teaching
"I will drink 2 to 3 L of fluids everyday"
"I will drink a glass of water whenever I feel thirsty"
"I will drink coffee and cola drinks throughout the day"
"I will avoid drinks containing alcohol"
the nurse has been floated to the telemetry unit for the day. the monitor technician informs the nurse that the patient has developed prominent U waves. which laboratory value should be checked immediately
sodium
potassium
magnesium
calcium
a patient's potassium level is 6.7 mEq/L (6.7 mmol/L). which intervention should the nurse delegate to the first-year student nurse under his or her supervision
administer sodium polystyrene sulfonate 15 g orally
administer spironolactone 25 mg orally
assess the electrocardiogram (ECG) strip for tall T waves
administer potassium 10 mEq (10 mmol/L) orally
a patient is admitted to the unit with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). for which electrolyte abnormality would the nurse be sure to monitor
hypokalemia
hyperkalemia
hyponatremia
hypernatremia
the charge nurse assigned the care of a patient with acute kidney failure and hypernatremia to a newly graduated RN. which actions can the new RN delegate to the assistive personnel (AP). select all that apply
providing oral care every 3 to 4 hours
administering 0.45% saline by IV line
recording urine output when patient voids
assessing daily weights for trends
helping the patient change position every 2 hours
an experienced LPN/LVN reports to the RN that a patient's blood pressure and heart rate have decreased and that when his face was assessed, one side twitched. what action should the RN take at this time
reassess the patient's blood pressure and heart rate
review the patient's morning calcium level
request a neurologic consult today
check the patient's pupillary reaction to light
the nurse is preparing to discharge a patient whose calcium level was low but is now just barely within the normal range (9 to 10.5 mg/dL). which statement by the patient indicates the need for additional teaching
"I will call my doctor if I experience muscle twitching or seizures"
"I will make sure to take my vitamin D with my calcium each day"
"I will take my calcium citrate pill every morning before breakfast"
"I will avoid dairy products, broccoli, and spinach when I eat"
which prescription for a patient with hypercalcemia would the nurse question
0.9% saline at 50 mL/hr IV
furosemide 20 mg orally each morning
apply cardiac telemetry monitoring
hydrochlorothiazide (HCTZ) 25 mg orally each morning
the assistive personnel (AP) asks the nurse why the patient with a chronically low phosphorus level needs so much assistance with activities of daily living, What is the RNs best response
"the patient's low phosphorus is probably because of malnutrition"
"the patient is just worn out from not getting enough rest"
"the patient's skeletal muscles are weak because of the low phosphorus"
"the patient will do more for himself when his phosphorus level is normal"
the RN is reviewing the patient's morning laboratory results. which of these results is of most concern
serum potassium level of 5.2 mEq/L (5.2 mmol/L)
serum sodium level of 134 mEq/L (134 mmol/L)
serum calcium level of 10.6 mg/dL (2.65 mmol/L)
serum magnesium level of 0.8 mEq/L (0.4 mmol/L)
which patient would the charge nurse assign to the step-down unit nurse who was floated to the ICU for the day
a 68 year old patient on a ventilator with acute respiratory failure and respiratory acidosis
a 72 year old patient with COPD and normal blood gas values who is ventilator dependent
a newly admitted 56 year old patient with diabetic ketoacidosis receiving an insulin drip
a 38 year old patient on a ventilator with narcotic overdose and respiratory alkalosis
the patient with respiratory failure is receiving mechanical ventilation and continues to produce arterial blood gas results indicating respiratory acidosis. which change in ventilator setting should the nurse expect to correct this problem
increase in ventilator rate from 6 to 10 breaths/min
decrease in ventilator rate from 10 to 6 breaths/min
increase in oxygen concentration from 30% to 40%
decrease in oxygen concentration from 40% to 30%
which actions should the nurse delegate to an assistive personnel (AP) for the patient with diabetic ketoacidosis. select all that apply
checking fingerstick glucose results every hour
recording intake and output every hour
measuring vital signs every 15 minutes
assisting the patient to reposition every 2 hours
notifying the health care provider of changes in glucose level
the nurse is admitting an older patient to the acute care medical unit. which assessment factor alerts the nurse that this patient has a risk for acid-base imbalances
history of myocardial infarction (MI) 1 year ago
antacid use for occasional indigestion
shortness of breath with extreme exertion
chronic renal insufficiency
a patient with lung cancer has received oxycodone 10 mg orally for pain. when the student nurse assesses the patient, which finding would the nurse instruct the student nurse to report immediately
respiratory rate of 8 to 20 breaths/min
decrease in pain level from 6 to 2 (on a scale of 1 to 10)
request by the patient that the room door be closed
heart rate of 90 to 100 beats/min
the assistive personnel (AP) reports to the nurse that a patient seems very anxious, and vital sign measurement included a respiratory rate of 38 breaths/min. which acid-base imbalance should the nurse suspect
respiratory acidosis
respiratory alkalosis
metabolic acidosis
metabolic alkalosis
a patient is admitted to the oncology unit for chemotherapy. to prevent an acid-base problem, which finding would the nurse instruct the assistive personnel to report
repeated episodes of nausea and vomiting
reports of pain associated with exertion
failure to eat all the food on the breakfast tray
patient hair loss during the morning bath
the patient has a nasogastric (NG) tube connected to intermittent wall suction. the student nurse asks why the patient's respiratory rate and depth has decreased. what is the nurse's best response
"it's common for patients with uncomfortable equipment such as NG tubes to have a lower rate of breathing"
"the patient may have a metabolic alkalosis because of the NG suctioning, and the decreased respiratory rate is a compensatory mechanism
"whenever a patient develops a respiratory acid-base problem, decreasing the respiratory rate helps correct the problem"
"the patient is hypoventilating because of anxiety, and we will have to stay alert for the development of respiratory acidosis"
the patient has an order for hydrochlorothiazide (HCTZ) 10 mg orally every day. what should the nurse be sure to include in a teaching plan for this drug? select all that apply
"take this medication in the morning"
"this medication should be taken in two divided doses: half when you get up and half when you go to bed"
"inform your health care provider if you notice wight gain or increased swelling"
"you should expect your urine output to increase"
"your HCP may also prescribe a potassium supplement"
which blood test result would the nurse be sure to monitor for the patient taking hydrochlorothiazide (HCTZ)
sodium level
potassium level
chloride level
calcium level
the RN is providing care for a patient diagnosed with dehydration and hypovolemic shock. which prescribed intervention from the health care provider should the RN question
blood pressure every 15 minutes
place two 18-gauge IV lines
oxygen at 3 L via nasal cannula
IV 5% dextrose in water (D5W) to run at 250 mL/hr
the student nurse, under the supervision of an RN, is reviewing a patient's arterial blood gas results and notes an acute increase in arterial partial pressure of carbon dioxide (Paco2) to 51 mmHG compared with the previous results. which statement by the student nurse indicated an accurate understanding of the acid-base balance for this patient
"when the Paco2 is acutely elevated, the blood pH should be lower than normal"
"this patient should be taught to breathe and rebreathe in a paper bag"
"an elevated Paco2 always means that a patient has an acidosis"
"when a patient's Paco2 is increased, the respiratory rate should decrease to compensate"
the nurse is providing care for several patients who are at risk for acid-base imbalance. which patient is most at risk for respiratory acidosis
a 68 year old patient with chronic emphysema
a 58 year old patient who uses antacids every day
a 48 year old patient with an anxiety disorder
a 28 year old patient with salicylate intoxication
the nurse is caring for a patient who experiences frequent generalized tonic-clonic seizures associated with periods of apnea. the nurse must be alert for which acid-base imbalance
respiratory alkalosis
respiratory acidosis
metabolic alkalosis
metabolic acidosis
the nurse is completing a history for an older patient at risk for an acidosis imbalance. which questions would the nurse be sure to ask? select all that apply
"which drugs to you take on a daily basis"
"do you have any problems with breathing"
"have you experienced any activity intolerance or fatigue in the past 24 hours"
"do you have episodes of drowsiness or decreased alertness"
"over the past month have you had any dizziness or tinnitus"
which specific instruction does the charge nurse give the assistive personnel helping to provide care for a patient who is at risk for metabolic acidosis
check to see that the patient keeps his oxygen in place at all times
inform the nurse immediately if the patient's respiratory rate and depth incrases
record any episodes of reflux or constipation
keep the patient's ice water pitcher filled at all times
