1. A nurse is caring for a client who has heart failure and a prescription for digoxin 125 mcg
PO daily. Available is digoxin PO 0.25 mg/tablet. How many tablets should the nurse
administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it
applies. Do not use a trailing zero.) _0.5_ tablet(s)
2. 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
3. A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which of the
following abnormalities on the client's EKG should the nurse interpret as a sign of hypokalemia?
A. Abnormally prominent U wave
B. Elevated ST segment
C. Wide QRS
D. Inverted P wave
4. A client who has a history of myocardial infarction (MI) is prescribed aspirin 325 mg. The
nurse recognizes that the aspirin is given due to which of the following actions of the
medication?
A. analgesic
B. anti-inflammatory
C. antiplatelet aggregate
D. antipyretic
5. While performing an admission assessment for a client, the nurse notes that the client has
varicose veins with ulcerations and lower extremity edema with a report of a feeling of
heaviness. Which of the following nursing diagnoses should the nurse identify as being the
priority in the client's care?
A. Impaired tissue perfusion
B. Alteration in body image
C. Alteration in activity tolerance
D. Impaired skin integrity
6. A nurse is assessing a client who is receiving one unit of packed RBCs to treat intraoperative
blood loss. The client reports chills and back pain, and the client's blood pressure is 80/64 mm
Hg. Which of the following actions should the nurse take first?
A. Stop the infusion of blood.
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B. Inform the provider.
C. Obtain a urine specimen.
D. Notify the laboratory.
7. A nurse is teaching the partner of a client who had an acute myocardial infarction (MI) about
the reason blood was drawn from the client. Which of the following statements should the
nurse make regarding cardiac enzymes studies?
A. "These tests help determine the degree of damage to the heart tissues."
B. "Cardiac enzymes will identify the location of the MI."
C. "These tests will enable the provider to determine the heart structure and mobility of
the heart valves."
D. "Cardiac enzymes assist in diagnosing the presence of pulmonary congestion."
8. A nurse is caring for a client who was admitted with bleeding esophageal varices and has an
esophagogastric balloon tamponade with a Sengstaken-Blakemore tube to control the bleeding.
Which of the following actions should the nurse take?
A. Ambulate the client four times per day.
B. Encourage the client to consume clear liquids.
C. Provide frequent oral and nares care.
D. Keep the client in a supine position.
9. A nurse is teaching about risk factors of developing a stroke with a group of older adult
clients. Which of the following nonmodifiable risk factors should the nurse include in the
teaching?
A. History of smoking
B. Obesity
C. History of hypertension
D. Race
10.A nurse is caring for a client who is postoperative and is at risk for developing venous
thromboembolism (VTE). The nurse should instruct the client to avoid which of the following
unsafe actions?
A. Elevating her feet
B. Massaging her legs
C. Flexing her ankles
D. Ambulating soon after surgery
11. A nurse is auscultating a client's heart sounds and hears an extra heart sound before what
should be considered the first heart sound S1. The nurse should document this finding as which
of the following heart sounds?
A. The fourth heart sound (S4)
B. A friction rub
C. The third heart sound (S3)
D. A split second heart sound S2
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12. A nurse on a medical-surgical unit is caring for four clients who are 24 to 36 hr
postoperative. Which of the following surgical procedures places the client at risk for deep-vein
thrombosis?
A. Myringotomy
B. Laparoscopic appendectomy
C. Hip arthroplasty
D. Cataract extraction
13.A nurse is caring for a client who is receiving a unit of packed red blood cells. Fifteen minutes
following the start of the transfusion, the nurse notes that the client is febrile, with chills and
red-tinged urine. Which of the following transfusion reactions should the nurse suspect?
A. Febrile
B. Allergic
C. Acute pain
D. Hemolytic
14. A nurse is assessing a client who had left femoral cardiac angiography. Identify where the
nurse will palpate to assess the most distal pulse on the affected side. (Check areas, or "Hot
Spots," as outlined in the artwork below. Select only the outlined area that corresponds to your
answer.)
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15. A nurse is caring for a client who has bleeding esophageal varices and is being treated with a
Sengstaken-Blakemore tube. Which of the following actions should the nurse perform?
A. Deflate the balloons for 5 min every 2 hr to prevent tissue necrosis.
B. Maintain constant observation while the balloons are inflated.
C. Suction the tube every 2 hr and as needed to maintain patency.
D. Keep the head of the bed flat at all times to prevent the development of shock.
16. A nurse is caring for a client who has pericarditis and reports feeling a new onset of
palpitations and shortness of breath. Which of the following assessments should indicate to the
nurse that the client may have developed atrial fibrillation?
A. Different blood pressures in the upper limbs.
B. Different apical and radial pulses.
C. Differences between oral and axillary temperatures.
D. Differences in upper and lower lung sounds.
17. A nurse is caring for a client who has an elevated potassium level and is on a cardiac
monitor. The nurse is aware that hyperkalemia may be associated with changes to the T-wave.
On the graphic, point and click on the area of the electrocardiogram (ECG) that represents the T-
wave. (Check on the Hot Spot that corresponds to your answer.)
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