{"id":113420,"date":"2023-08-16T01:00:59","date_gmt":"2023-08-16T01:00:59","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=113420"},"modified":"2023-08-16T01:01:01","modified_gmt":"2023-08-16T01:01:01","slug":"adult-health-lll-exam-1-4-final-exam-latest-versions-2023-2024-real-exam-questions-and-correct-answersgraded-a","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2023\/08\/16\/adult-health-lll-exam-1-4-final-exam-latest-versions-2023-2024-real-exam-questions-and-correct-answersgraded-a\/","title":{"rendered":"ADULT HEALTH lll EXAM 1-4 &amp; FINAL EXAM LATEST VERSIONS 2023-2024 REAL EXAM QUESTIONS AND CORRECT ANSWERS|GRADED A+"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">ADULT HEALTH lll EXAM 1-4 &amp; FINAL<br>EXAM LATEST VERSIONS 2023-2024 REAL<br>EXAM QUESTIONS AND CORRECT<br>ANSWERS|GRADED A+<br>Adult Health lll Exam 1<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>The nurse should interpret the arterial blood gas results shown below as which of the following?<br>pH 7.48, PaO2 85 mm Hg, PaCO2 32 mm Hg, and HCO3 25 mEq\/L<br>a. respiratory alkalosis<br>b. metabolic acidosis<br>c. metabolic alkalosis<br>d. respiratory acidosis<br>Feedback: The ABGs shown indicate the pH is high which would mean alkalosis. The PaCO2 is low<br>which is the opposite of the pH and indicates that the respiratory system is the primary problem. The<br>HCO3 is within normal levels. Remember the acronym ROME when interpreting ABGs.Lewis 2017, pgs<br>290-291abcK<\/li>\n\n\n\n<li>The nurse is caring for a client who is receiving prescribed intravenous (IV) fluids at 50 ml\/hr,<br>has voided 300 ml in 24-hours and reports having a headache. The nurse notes the client&#8217;s<br>laboratory results show a low urine specific gravity level. Which of the following actions should<br>the nurse take?<br>a. Encourage the client to increase their fluid intake.<br>b. Decrease the intravenous fluids.<br>c. Administer prescribed antibiotics.<br>d. Assist the client to ambulate to increase their metabolic rate.<br>Feedback: Acute renal failure manifests as oliguria, anuria, or normal urine volume. Oliguria (less than<br>400 mL\/d of urine) is the most common clinical situation seen in acute renal failure along with a low<br>urine specific gravity; anuria (less than 50 mL\/d of urine) and normal urine output are not as common. In<br>acute renal failure you want to encourage the client to increase their fluid intake to prevent dehydration.<br>Administering antibiotics will not increase the client&#8217;s decreased urine output. Decreasing IV fluids will<br>be putting the client at risk for dehydration. Increasing the metabolic rate will not assist the client in their<br>urine output deficit. Lewis 2017, pgs. 1071-1072abkd<\/li>\n\n\n\n<li>The plan of care for a client with a low potassium level includes providing information about the<br>effects of medications and the dietary intake of foods high in potassium. Which of the following<br>information should the nurse use to evaluate if the outcome for the plan was met?<br>a. laboratory data<br>b. physical assessment<br>c. health history<br>d. client statements<br>Feedback: The interventions are aimed at increasing the potassium level of the client, and achievement<br>would be measured by evaluating laboratory data. Potassium levels cannot be measured by physical<br>assessment, health history information, or client statements. Lewis 2017, pgs. 282-283<\/li>\n\n\n\n<li>The nurse caring for a client experiencing acute hypoxemic respiratory failure due to V\/Q<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">mismatch is evaluating the client\u2019s plan of care. Which of the following interventions would be<br>appropriate for the client\u2019s care plan?<br>a. Initiate 24% to 32% oxygen via face mask.<br>b. Provide high flow supplemental oxygen via nasal cannula.<br>c. Provide oxygen via noninvasive positive pressure ventilation (NIPPV).<br>d. Initiate invasive positive pressure ventilation (PPV) via endotracheal tube for SaO2 below 90%.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Feedback: The nurse should understand that acute hypoxemic respiratory failure due to V\/Q mismatch<br>requires low levels of oxygen either via nasal cannula or using a face mask at 24% to 32% oxygen. This<br>helps improve the PaO2 and SaO2 levels. Without knowing the client\u2019s baseline SaO2 an intervention to<br>initiate PPV vie ET tube for SaO2 would be inappropriate. NIPPV is typically the treatment of choice for<br>hypoxemia secondary to an intrapulmonary shunt, not V\/Q mismatch.Lewis 2017, pgs. 1615-1616<\/p>\n\n\n\n<ol class=\"wp-block-list\" start=\"5\">\n<li>The nurse is caring for a client with right sided pneumonia (PN) and helps position the client in<br>the left Sims position. The nurse should evaluate the client\u2019s response to the position by doing<br>which of the following?<br>a. Compare the client\u2019s PaO2 level with the previous level.<br>b. Assessing the client\u2019s pain level.<br>c. Ask the client to perform coughing and deep breathing.<br>d. Compare the client\u2019s pH and HCO3 levels with the baseline levels.<br>Feedback: Clients with unilateral lung disease should be positioned with the healthy lung in a dependent<br>position. This helps to mobilize the secretions which makes it easier to expectorate. The client\u2019s PaO2<br>level compared to the previous level would give the nurse a good indication if the client\u2019s ventilation has<br>increased. Lewis 2017, pgs. 1610-1611k, 1624-1625k, acd by omission<\/li>\n\n\n\n<li>The nurse is caring for a client with acute respiratory distress syndrome (ARDS) who is<br>mechanically ventilated with positive end-expiratory pressure (PEEP). Which of the following<br>should alert the nurse that the client is having complications from PEEP? Select all that apply.<br>a. tachycardia<br>b. hypopnea<br>c. decreased urine output<br>d. diminished lung sounds<br>e. hypertension<br>Feedback: PEEP is indicated in clients with ARDS. PEEP provides positive pressure at the end of<br>expiration to keep the alveoli open. This positive pressure can increase the intrathoracic pressure. When<br>intrathoracic pressure increases, the client will have a decrease in preload, which can decrease cardiac<br>output. When there is a decrease in cardiac output, the client can have tachycardia, hypotension, and<br>decreased perfusion to the kidneys. With increased intrathoracic pressure, barotrauma or pneumothorax<br>can occur. A client on mechanical ventilation should have equal and bilateral breath sounds, diminished<br>breath sounds may indicate a pneumothorax.Lewis 2017, pg. 1577Kbe<\/li>\n\n\n\n<li>The nurse received report from the previous shift for a client who was intubated for acute<br>respiratory failure (ARF) less than one hour ago. Which of the following test results would be a<br>priority for the nurse to follow-up?<br>a. end-tidal CO2 (ETCO2)<br>b. complete blood count (CBC)<br>c. electrocardiogram (ECG)<br>d. mixed venous O2 saturation (SvO2)<br>Feedback: After a client is intubated the ETCO2 should be evaluated because this confirms proper tube<br>placement within the airway immediately after intubation. A CBC, ECG and SvO2 are also done after<br>intubation but would not be a priority over correct tube placement.Lewis 2017, p. 1614<\/li>\n\n\n\n<li>A nurse is caring for a client in the emergency department (ED) who had a radiograph (x-ray) that<br>reveals rib fractures, and the client is diagnosed with a small flail chest injury. Which of the<br>following interventions should the nurse include in the client&#8217;s plan of care?<br>a. suction the client&#8217;s airway secretions<br>b. strict fluid intake and fluid replacement restriction<br>c. prepare the client for surgery<br>d. immediately sedate and intubate the client<br>Feedback: As with rib fracture, treatment of flail chest is usually supportive. Management includes<br>ventilatory support, clearing secretions from the lungs, and controlling pain. If only a small segment of<br>the chest is involved, it is important to clear the airway through positioning, coughing, deep breathing,<br>and suctioning. Clients should have adequate fluid intake and replacement to mobilize secretions and<br>underlining pulmonary contusion. Intubation is required for severe flail chest injuries, and surgery is<br>required only in rare circumstances to stabilize the fail segment.Lewis 2017, pgs. 521-522kbcd, 1610k<\/li>\n\n\n\n<li>The nurse is caring for a client who is receiving positive pressure ventilation and high levels of<br>PEEP via endotracheal intubation for acute respiratory distress syndrome (ARDS). The nurse<br>should contact respiratory therapy for which of the following findings?<br>a. The client\u2019s FIO2 is at 65%.<br>b. The client\u2019s PaO2 is at 75%.<br>c. The client\u2019s blood pressure decreased from 110\/68 mm\/Hg to 89\/60 mm\/Hg in the last hour.<br>d. The client\u2019s temperature increased from 98.8o F. to 100.1o F in the last hour.<br>Feedback: The nurse should contact respiratory therapy for a the decrease in blood pressure. Client\u2019s<br>receiving high levels of PEEP can experience a reduction in blood return to the left side of the heart from<br>hyperinflation of the alveoli and compression of the pulmonary capillary bed which then causes dramatic<br>reduction in BP. The PEEP should be adjusted to correct the BP. The client\u2019s temperature is unrelated to<br>respiratory therapy and the FIO2 and PaO2 are within expected levels. Lewis 2017, pg. 1624Kbc, d by<br>omission.<\/li>\n\n\n\n<li>The nurse is assessing a client with chronic obstructive pulmonary disease (COPD). The nurse<br>auscultates diminished breath sounds, which is a change from the client&#8217;s baseline. The nurse<br>should monitor the client for which of the following potential complications?<br>a. dyspnea and hypoxemia<br>b. kyphosis and clubbing of the fingers<br>c. sepsis and pneumothorax<br>d. bradypnea and pursed lip breathing<br>Feedback: These changes in the airway require that the nurse monitor the client for dyspnea and<br>hypoxemia. Kyphosis is a musculoskeletal problem. Sepsis and pneumothorax are atypical complications.<br>Tachypnea is much more likely than bradypnea. Pursed lip breathing can relieve dyspnea. Lewis 2017, p.<br>564k, acd by omission, 1610-1611k<\/li>\n\n\n\n<li>The nurse is providing telephone triage and is speaking with the spouse of a client with asthma<br>who has a prescription for a short-acting inhaled beta-agonist to utilize as needed. The spouse<br>states, &#8220;My spouse\u2019s personal best peak flow reading is 290 L\/minute and today the reading is 220<br>L\/minute.&#8221; Which of the following would be an appropriate response by the nurse?<br>a. &#8220;This is a medical emergency take your spouse to the nearest emergency department (ED).&#8221;<br>b. &#8220;Your spouse should use the prescribed beta-agonist inhaler.&#8221;<br>c. &#8220;A prescription for intravenous corticosteroids is most likely necessary.&#8221;<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>ADULT HEALTH lll EXAM 1-4 &amp; FINALEXAM LATEST VERSIONS 2023-2024 REALEXAM QUESTIONS AND CORRECTANSWERS|GRADED A+Adult Health lll Exam 1 mismatch is evaluating the client\u2019s plan of care. Which of the following interventions would beappropriate for the client\u2019s care plan?a. Initiate 24% to 32% oxygen via face mask.b. Provide high flow supplemental oxygen via nasal cannula.c. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-113420","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/113420","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=113420"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/113420\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=113420"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=113420"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=113420"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}