NURSING 428 Trends Exit Exam Questions with Answers
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NURSING 428
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NURSING 428
NURSING 428 Trends Exit Exam Questions with Answers
1. The nurse assesses a client one hour after starting a transfusion of packed RBC and determines that there are no indicators of a transfusion reaction. What instruction should the nurse provide the unlicensed assistive personnel UAP who is ...
nursing 428 trends exit exam questions with answers 1 the nurse assesses a client one hour after starting a transfusion of packed rbc and determines that there are no indicators of a transfusion re
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NURSING 428 Trends Exit Exam
Questions with Answers
1. The nurse assesses a client one hour after starting a transfusion of packed RBC and determines
that there are no indicators of a transfusion reaction. What instruction should the nurse provide
the unlicensed assistive personnel UAP who is working with the nurse?
a. Notify the nurse when the transfusion has finished, so further client assessment can be done
b. Monitor the client carefully for the next three hours and report the onset of the
reaction immediately
c. Continue to measure the client’s vital signs every thirty minutes until transfusion is complete
d. Since a reaction did not occur, the priority is to maintain client comfort during the transfusion
2. An older client is brought to the clinic for appointment by a grandson. The client is withdrawn
and allows the grandson to answer the nurse’s questions. The nurse observes the grandson
makes frowning facial expressions and shakes his head sighing when speaking to the client.
Which action the nurse take next?
a. Ask the client if an assisted living facility has been considered
b. Request social services to make a home visit
c. Interview the client privately without the family member present
d. Complete a neurological and musculoskeletal assessment
3. The mother of an adolescent female tells the clinic nurse that after every meal her daughter
goes to the bathroom, locks the door and vomits. Which physical assessment should the nurse
implement if bulimia is suspected?
a. Skin of palms of the hand
b. Current height and weight
c. Condition of tooth enamel
d. Length of the last menses
4. A new nurse preparing to irrigate an intravenous catheter is attaching a 24-guage needle. Which
action should the charge nurse implement?
a. Prompt the nurse to apply povidone to the site
,b. Suggest the nurse use a 20-guage needle
c. Direct the nurse to change the IV tubing
d. Instruct the nurse to remove the needle
,5. After a spider bite on the lower extremity, a client is admitted for treatment of an infection that
is spreading up the leg. Which admission assessment findings should the nurse report to the
healthcare provider? SATA
a. Location of the initial IV site
b. Swollen lymph nodes in the groin
c. White blood cell count (WBC)
d. Core body temperature
e. Red blood cell count (RBC)
6. A client has an abdominal wound dehiscence when the surgical staples are removed. What
intervention should the nurse implement first.
a. Place the client in protective (reverse) isolation
b. Notify the surgeon immediately
c. Place a saline dressing over the wound
d. Assess the client’s bowel sounds
7. After an older client receives treatment for drug toxicity, the healthcare provider prescribes a
24- hour creatinine clearance test. Prior to starting the urine collection, the nurse notes that the
client ‘s serum creatinine is 0.3mg/dL (22.9 micro….). which action should the nurse implement?
a. Assess the client for signs of hypokalemia
b. Initiate the urine collection as prescribed
c. Notify the healthcare provider of the results
d. Evaluate the client’s serum BUN level
8. The nurse is preparing to administer histamine 2 -receptor antagonist to a client with peptic
ulcer disease. What is the primary purpose of this drug?
a. Destroys microorganisms causing stomach inflammation
b. Neutralizes hydrochloric acid (HCl) in the stomach
c. Inhibits action of acetylcholine by blocking parasympathetic nerve endings
d. Decreases the amount of HCI secretion by the parietal cells in the stomach
, 9. The nurse is working in a critical care unit is assigned the care of two clients, one with
pneumonia who is being mechanically ventilated and the other who had a thoracotomy
yesterday and is complaining of incisional pain. What should the nurse do first?
a. Assess the level of consciousness and vital signs for both clients
b. Complete a head-to-toe assessment of the client with pneumonia
c. Change the surgical dressing to observe the appearance of the incision
d. Review the plan of care and the medications that are due to both clients
10. Which client should the charge nurse on the oncology unit assign to an RN, rather than a
practical nurse (PN)?
a. An adult client in remission after a series of chemotherapy treatments who is receiving
intramuscular iron injections for anemia
b. A middle-aged male client who has just undergone an excisional biopsy and has been told that
his tumor appears to be benign
c. A young adult client who is experiencing fatigue while undergoing a series of external beam
radiation treatments for stage one cancer
d. An elderly female client with cancer whose children who are trying to decide whether to
change to palliative care measures or continue disease Control
11. A client is admitted to the intensive care unit with diabetes insipidus due to a pituitary gland
tumor. Which potential complication should the nurse monitor closely?
a. Peripheral edema
b. Ketonuria
c. Elevated blood pressure
d. Hypokalemia
12. An adult is admitted to the emergency department following ingestion of a bottle of
antidepressants secondary to chronic pain. A nasogastric tube and left subclavian venous
catheter are placed. The nurse auscultates audible breath sounds on the right side, faint sounds
on the left side, and chest movement that occurs only on the right side of the thorax. Which
procedure should the nurse prepare for first?
a. Insertion of a left-sided chest tube
b. Set-up of patient-controlled analgesia
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