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RNSG NURS 315ADULTHESICUMULATIVEQUESTIONSANSWERKEYFALL2021.
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RNSG NURS 315ADULTHESICUMULATIVEQUESTIONSANSWERKEYFALL2021.1.A nurse is admitting a client who has acute pancreatitis. Which of the following provider prescriptions should the nurse
anticipate?
A. Initiate a low-residue diet.
Rationale: One of the manifestations of acute pancreatitis is abdominal pain. The nurse should
anticipate the provider will prescribe withholding of foods and fluids. This serves to
manage the client's pain by limiting gastrointestinal activity and stimulation of the
pancreas.
B. Pantoprazole 80 mg IV bolus twice daily
Rationale: The nurse should anticipate a provider's prescription for a proton pump inhibitor to
decrease gastric acid production, which ultimately decrease pancreatic secretions.
C. Ambulate twice daily.
Rationale: The nurse should anticipate a provider prescription for bed rest during the acute
stage of pancreatitis. Bed rest decreases the metabolic rate and the secretion of
pancreatic enzymes.
D. Pancrelipase 500 units/kg PO three times daily with meals
Rationale: The nurse should identify that pancrelipase, an enzyme replacement medication, is
used in the treatment of clients who have chronic pancreatitis. It is not used in the
treatment of acute pancreatitis.
2.A nurse is admitting a client who has active tuberculosis to a room on a medical-surgical unit. Which of the following room
assignments should the nurse make for the client?
A. A room with air exhaust directly to the outdoor environment
Rationale: A room with air exhaust directly to the outside environment eliminates
contamination of other client-care areas. This type of ventilation system is referred
to as an airborne infection isolation room.
B. A room with another nonsurgical client
Rationale: A two-bed room with another nonsurgical client exposes the other client to
tuberculosis. A client who has tuberculosis should have a private room.
C. A room in the ICU
Rationale: A client who has active tuberculosis and no other comorbidities is not critically ill.
D. A room that is within view of the nurses' station
Rationale: The client's room should be well ventilated and private, but it is not necessary for it
to be close to the nurses' station.
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3.A nurse is caring for a client who has a new diagnosis of urolithiasis. Which of the following should the nurse
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, RNSG NURS 315ADULTHESICUMULATIVEQUESTIONSANSWERKEYFALL2021.
identify as an associated risk factor?
A. Hypocalcemia
Rationale: Hypercalcemia is a risk factor associated with urolithiasis.
B. BMI less than 25
Rationale: Obesity, or having a BMI that is greater than 29, has been found to be a risk factor
for the development of urolithiasis.
C. Family history
Rationale: Family history is strongly correlated with the formation of urolithiasis. A nurse
should assess a client who has kidney stones for familial tendencies toward stone
formation.
D. Diuretic use
Rationale: Medications such as antacids, vitamin D, laxatives, and aspirin have been
associated with the formation of urolithiasis. However, there is no indication that
the use of diuretics place a client at an increased risk for stone formation.
4.A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse expect? (Select all
that apply.)
A. Increased heart rate
B. Increased blood pressure
C. Increased respiratory rate
D. Increase hematocrit
E. Increased temperature
Rationale: Increased heart rate is correct. The nurse should expect the client who has fluid
volume excess to have tachycardia and increased cardiac contractility in response
to the excess fluid.Increased blood pressure is correct. The nurse should expect the
client who has fluid volume excess to have increased blood pressure and bounding
pulse in response to the excess fluid.Increased respiratory rate is correct. The nurse
should expect the client who has fluid volume excess to have increase in respiratory
rate and moist crackles heard in lungs.Increased hematocrit is incorrect. The nurse
should expect the client who has fluid volume deficit to have an elevated
hematocrit because of hemoconcentration.Increase temperature is incorrect. The
nurse should expect the client who has fluid volume deficit to have an increase in
temperature due to fluid loss.
5.A nurse is administering a tap water enema to a client who is constipated. During the administration of the enema, the
client states he is having abdominal cramps. Which of the following actions should the nurse take to relieve the client's
discomfort?
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, RNSG NURS 315ADULTHESICUMULATIVEQUESTIONSANSWERKEYFALL2021.
A. Lower the height of the solution container.
RATIONALE:
Created on:11/20/2021 Page 4
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