NUR301 final exam 2024 latest update with solutions
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NUR301
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NUR301
NUR301 final exam 2024 latest update with solutions NUR301 final exam 2024 latest update with solutions NUR301 final exam 2024 latest update with solutions NUR301 final exam 2024 latest update with solutions NUR301 final exam 2024 latest update with solutions NUR301 final exam 2024 latest update wi...
nur301 final exam 2024 latest update with solution
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NUR301 final exam 2024 latest update with solutions
The nurse understands which is the cause of respiratory alkalosis?
A. hyperglycemia
b. hyperventilation
c. fluid loss
d. airway compromise - ANSWERSb. hyperventilation
the nurse instructs a pt how to use an incentive spirometer. which statement by the pt shows
that teaching is effective?
a. i should take a deep breathe and blow into the mouthpiece
b. im glad i only have to do this twice a day
c. i can ask for pain medication prior to using the spirometer
d. i should lie down to use the spirometer - ANSWERSc. i can ask for pain medication prior
to using the spirometer
rationale: the pt will put the mouthpiece in the mouth and close the lips tightly around it. the
pt will slowly exhale completely. the pt will then inhale slowly and deeply to make the piston
rise
the nurse identifies which client is most at risk for developing pneumonia?
a. a client with a urinary catheter
b. a client with an ng tube
c. a client with psoriasis
d. a client with paget disease - ANSWERSb. a client with an ng tube
when assessing a client for tactile remitUs, which part of the hand does the nurse use?
a. fingertips and finger pads
b. dorsal surface of the hand
c. ulnar and palmar surface of the hand
d. dorsiflexed surface of the wrist - ANSWERSc. ulnar and palmar surface of the hand
rationale: the nurse asks the pt to say the number "99". tactile remits is palpable vibrations
that will increase when lung consolidation exists such as with pneumonia, and decreased with
pleural effusion, pneumothorax, bronchial obstruction or air trapping occurs
a pt is admitted into the hospital with a diagnosis of acute right upper lobe pneumonia. the pt
has a history of chronic bronchitis. which symptom does the nurse expect to see?
,a. moist, cool skin
b. rust-colored sputum
c. bradycardia
d. decreased respiratory rate - ANSWERSb. rust-colored sputum
rationale: rust colored sputum, or blood-tinged due to inflammation is a typical finding for
pneumonia. the pt may also have increased respirations, dyspnea, coughing, and pleuritic
pain. treatment includes antibiotics, supplemental oxygen, and chest pt. the nurse should
assess breath sounds, VS including pulse oximetry. the nurse should encourage coughing and
deep breathing every 2 hours and increased fluids
the nurse places a pulse oximetry probe on a pt. the pt asks "why do i have this thing on me?"
which response by the nurse is the best?
a. it enables your IV fluids to run
b. it monitors your pulse rate
c it tells us if your BP is within normal limits
d it measures the amount of oxygen circulating in your blood - ANSWERSd it measures the
amount of oxygen circulating in your blood
on the first post day, a pt developed a fever. the nurse auscultates crackles bilaterally in the
lower lobes. the nurse understands which complication of surgery is probably developing?
a. HF
b. thromophlebitis
c. PE
d. atelectasis - ANSWERSd. atelectasis
rationale: general anesthesia is a common cause of atelectasis. atelectasis occurs when
secretions block the bronchioles and the alveoli collapse, causing hypoventilation. deep
breathing excercies and coughing after surgery can reduce the pt's risk of developing this
the nurse monitors a client receiving oxygen per face mask. the nurse is most concerned with
which observation
a. there is condensation in the tubing
b. the pulse oximetry reading is 92%
c. the client has a nonproductive cough
d. the skin under the elastic band is reddened - ANSWERSc. the client has a nonproductive
cough
,rationale: this is a sign of lung oxygen toxicity
which objective data is most important when determining if a pt is hypoxic?
a. cool, bluish skin
b. abnormal blood gases
c. elevated temperature
d. increased sputum production - ANSWERSb. abnormal blood gases
rationale: arterial blood gases (ABG) measures tissue oxygenation, co2 removal, and acid-
base balance. if the pt has inadequate exchange of oxygen and co2, respiratory acidosis
occurs
the nurse identifies which type of food is most likely to present problems for a pt with
respiratory issues?
a fruits
b grains
c dairy
d fish - ANSWERSc dairy
rationale: dairy products are mucus producing which can cause thick secretions
after receiving hand off shift report, the nurse assesses a pt who is having cheyne-stokes
respirations. which is the best description of this breathing pattern?
a. regular but increased in rate and abnormally deep respirations
b. irregular patterns of shallow breathing alternating with periods of apnea
c. regular rapid and shallow breathing
d. gradual increase in depth of respirations, followed by a gradual decrease in depth, then a
period of apnea - ANSWERSd. gradual increase in depth of respirations, followed by a
gradual decrease in depth, then a period of apnea
after oxygen had been administered, the next priority intervention the nurse would initiate for
a pt with a pulmonary embolism is the administration of which of the following therapies?
a. normal saline IV fluid
b. IV heparin
c. platelet administration
d. antibiotics for inflammatory fever - ANSWERSb. IV heparin
, a pt diagnosed with pneumonia complains of a new onset slight SOB. for which of the
following assessment findings would the nurse call the doctor immediately? (select all that
apply
a. the pt is voiding, but amounts are decreasing
b. the pt is sleeping more than usual
c. there is pink coloration to the skin
d. the pt's secretions are thin and milky colored
e. the pt thought it was the 3rd instead of the 5th of the month - ANSWERSb. the pt is
sleeping more than usual
c. there is pink coloration to the skin
the nurse includes which nursing diagnosis in the plan of care for a pt with pneumonia?
a anxiety related to hypoxia
b. deficient knowledge related to cause of disorder
c. fear related to threat of pain
d. ineffective breathing pattern related to decreased surfactant - ANSWERSa anxiety related
to hypoxia
the nurse is reviewing orders on the pt who is to receive supplemental oxygen. it is a priority
for the nurse to follow up with the provider about which order?
a. nasal cannula at 2 l/min
b. venturi mask at 24% concentration
c. nasal cannula at 8 l/ min
d. venturi mask at 50% concentration - ANSWERSc. nasal cannula at 8 l/ min
rationale: nasal cannulas are at 1-6 l/min
the nurse is caring for a pt who is receiving oxygen therapy via the venturi mask. which
complications are associated with oxygen therapy? select all that apply
a. oxygen toxicity
b. cachexia
c. bradycardia
d. absorption atelastasic
e. increased dead space - ANSWERSa. oxygen toxicity
e. increased dead space
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