STUVIA 2024/2025
ARCHER - READINESS ASSESSMENT #1 (5.0
review) HARD QUESTIONS
The nurse is caring for a 14-year-old scheduled for an appendectomy. What is the nurse's role in
obtaining informed consent before surgery? Select all that apply.
Informing the parents that only the surgeon may withdraw the surgical consent
Review the risks and benefits of the surgery with the parents
Validate that the parents are competent to provide consent for the client
Witness the signature on the informed consent
Make sure that the consent is witnessed by two healthcare professionals
The charge nurse is planning client care assignments for a registered nurse (RN) and licensed
practical/vocational nurse (LPN/VN). Which of the following clients would be most appropriate to
assign to the LPN? Select all that apply. A client
receiving oral antibiotics for lower extremity cellulitis.
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newly admitted with an exacerbation of myasthenia gravis.
with a chest tube and receiving mechanical ventilation.
requiring a referral to an outpatient support group.
needing to receive intramuscular RhoGAM.
needing scheduled tube feedings and colostomy irrigations.
The nurse is caring for a client with Buerger's disease. The nurse plans on suggesting that the client
receive a referral for
A. occupational therapy.
B. speech therapy.
C. smoking cessation.
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D. group psychotherapy.
Explanation
Choice C is correct. Arterial and venous blood flow impediments characterize Buerger's disease.
This impediment is caused by inflammation and is significantly worsened by smoking. The nicotine
causes vasoconstriction and worsens blood flow. A critical intervention for a client with this condition
is discussing smoking cessation with this client.
Choices A, B, and D are incorrect. These types of therapies are not pertinent to Buerger's disease.
The mainstay treatment is smoking cessation and prescribed vasodilators such as calcium channel
blockers.
Additional Info
Buerger's disease is characterized by arterial and venous inflammation worsened by smoking. The
nurse should advocate for smoking cessation to minimize symptoms. Prescriptive treatments include
calcium channel blockers (verapamil) or phosphodiesterase inhibitors (cilostazol).
The nurse is assessing a client with infective endocarditis (IE). Which of the following would be an
expected finding? Select all that apply.
Fever
Night sweats
Osler nodes
Cardiac murmur
Syncope
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Weight loss
The nurse is providing discharge instructions to a client with hepatitis A. Which of the following
instructions should the nurse include?
A. You will need to take daily showers or baths with chlorhexidine.
B. It is important to clean common surfaces with warm soapy water.
C. You will need to have repeat stool testing to determine if you are still infectious.
D. Check with your primary healthcare provider prior to taking any medications.
Explanation
Choice D is correct. While a client is being treated for hepatitis, they should consult with their
primary healthcare provider, so they are not taking any medications or substances that are
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hepatotoxic. Exposing a client with hepatitis to a hepatotoxic medication would significantly
complicate their recovery.
Choices A, B, and C are incorrect. Having the client shower with chlorhexidine is not an appropriate
teaching point for hepatitis A. The pathogen spreads through contaminated food, water, and surfaces.
The primary mode of transmission is fecal-oral. Surfaces contaminated with hepatitis should be
sanitized with a bleach solution, not warm soapy water. Repeat stool testing is not indicated for
hepatitis as diagnosis of hepatitis is made through serum hepatitis-A antibodies.
The nurse is teaching a client about newly prescribed isoniazid (INH) for pulmonary tuberculosis.
Which of the following statements by the client would require follow up?
A. "I will have to take this medication for three months."
B. "I will need to have my blood drawn periodically to see if I am having an adverse effect to this
medication."
C. "I will not be considered infectious if I have three consecutive negative sputum samples."
D. "This medication may make my hands and feet have numbness and tingling sensations."
Explanation
Choice A is correct. This statement requires follow-up because it is not accurate. Antitubculin
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medications must be taken for six to nine months to complete treatment and prevent resistance. If the
client is at risk of poor treatment adherence, they may be ordered directly observed therapywhere an
individual supervises the client to take their medication.
Choice B is incorrect. This statement is accurate and does not require follow-up because INH may
cause hepatic injury and blood dyscrasias. The client will need periodic blood specimen collections to
determine if they are experiencing anemia, transaminitis, or thrombocytopenia.
Choice C is incorrect. The client will be considered noninfectious if they have three consecutive
negative sputum tests for acid-fast bacilli (AFB). One of the sputum specimens must be collected in
the morning.
Choice D is incorrect. INH may cause a client to experience peripheral neuropathy, described as a
pins and needles sensation. This is why a client is prescribed pyridoxine to attenuate these
sensations.
Additional Info
✓ INH is the first-line therapy for pulmonary tuberculosis.
✓ This agent is often combined with another antitubercular medication because of emerging drug
resistance.
✓ Hepatotoxicity is the most common adverse effect of most antitubercular drugs.
✓ The client should immediately report signs of hepatotoxicity, such as jaundice and clay-colored
stools.
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✓ INH may cause a client to develop peripheral neuropathies. Pyroxidine (vitamin B6) is commonly
prescribed to prevent this occurrence.
The nurse is preparing a 3-year-old child for an incision and drainage of a large left leg abscess. The
nurse understands which of the following types of anesthesia will be administered to the child?
A. Peripheral nerve block
B. Spinal anesthesia
C. General Anesthesia
D. Local Anesthesia
Explanation
Choice C is correct. A large leg abscess will need significant time for incision and drainage (I&D).
Children who are not yet adolescents are not mature enough to cooperate adequately during such
surgical procedures. Children undergoing most surgeries require general anesthesia because this
minimizes their fears of intrusive or mutilating procedures. General anesthesia provides necessary
sedation so the surgery can be safely performed.
Choice A is incorrect. A peripheral nerve block will not be able to provide adequate anesthesia to
proceed with the I&D procedure of a large leg abscess. For the child to cooperate with such surgery,
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sedation is necessary. General anesthesia provides necessary analgesia and sedation to the child.
Choice B is incorrect. Although spinal anesthesia may achieve an analgesic effect, the child still
may not cooperate with the surgical procedure because spinal anesthesia does not provide sedation.
Choice D is incorrect. Local anesthesia is helpful while addressing small abscesses. A large
abscess requires more time and requires the child to cooperate. Children undergoing such
procedures require general anesthesia to provide necessary sedation as well because this minimizes
their fears of intrusive or mutilating procedures.
The nurse is developing a plan of care for a client diagnosed with Addison’s disease. Which of the
following should the nurse include in the client’s plan of care?
Select all that apply.
Diet high in potassium
Continuous telemetry monitoring
Intravenous hydrocortisone
Fluid restriction
Fall precautions
Indwelling urinary catheter
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