PREBOARD 7 JULY 31, 2021

PREBOARD 7 (JULY 31, 2021)

1.) The nurse is preparing a client who had a Roux-en-Y gastric bypass (RYGB) for discharge from the hospital. What information should the nurse plan to include related to the prevention of dumping syndrome?

• Meals should be small and low in carbohydrate content
• Fluids should be encouraged with each meal
• Take a multivitamin with iron and calcium supplements daily
• You will need to take your cobalamin injection monthly

2.) The nurse is changing the dressing, injection caps, and IV tubing of a client who is receiving total parental nutrition through a right peripherally inserted central venous catheter. The nurse should implement what actions to prevent complications during this procedure? Select all that apply.

• Instruct the client to hold the breath when changing the injection caps and tubing
• Instruct the client to keep the head to the right side during the dressing change
• Perform hand hygiene before and after the procedure
• Place the client in the Trendelenburg position before the procedure
• Wear sterile gloves and a surgical mask when changing the dressing

3.) A client who is intubated and on mechanical ventilation is receiving continuous enteral tube feedings at 30 mL/hr via a small-bore nasogastric tube. Which actions should the nurse take to prevent aspiration in this client? Select all that apply.

• Assess abdominal distension every 4 hours
• Check gastric residual every 12 hours
• Keep head of the bed at >30 degrees
• Maintain endotracheal cuff pressure
• Use caution when administering sedatives

4.) The nurse inserts a urinary catheter into a female client who has not voided for 6 hours. No urine is returned. What action should the nurse take next?

• Leave the catheter in place and insert a new catheter higher up in the perineal area
• Leave the catheter in place for 30 minutes and then recheck
• Notify the prescribing health care provider that there is an obstruction
• Remove the catheter and reinsert it at a position higher than the initial insertion

5.) The emergency department nurse cares for 5 clients. Which of the clients below are at risk for developing metabolic acidosis? Select all that apply.

1.25-year-old client with claustrophobia who was stuck in an elevator for 2 hours

• 36-year-old client with food poisoning and severe diarrhea for the past 3 days
• 40-year-old client with 3-day history of chemotherapy-induced vomiting
• 75-year-old client with pyelonephritis and hypotension
• 82-year-old client due for hemodialysis with clotted arteriovenous shunt

6.) The nurse is planning care for an 11-year-old admitted for surgical treatment of a fractured femur. The child also has attention-deficit hyperactivity disorder, predominantly inattentive type.What is the priority nursing action?

• Encourage the child to keep up with school work
• Give the child a written schedule of daily activities
• Limit the number of visitors
• Provide verbal explanations of what to expect during hospitalization

7.) You are receiving report from a nurse at another hospital who will be transferring a patient to your ICU. The patient has a Sengstaken-Blackmore Tube. Which of the following statement is incorrect about this tubing?

• It is a four-lumen gastric tube
• It is used in patient’s with esophageal varices
• A NG tube is inserted in the opposite nare to collect secretions
• Scissors are kept at the beside at all times with this tubing type

8.) Your patient has a PEG tube and you are about to administer a feeding. While checking residual you obtain 95 ml of stomach contents. What would be your next nursing intervention?

• Hold the feeding and immediately notify the MD of the assessed amount of residual
• Administered the scheduled feeding
• Wait 30 minutes and reassess residual
• Skip this scheduled feeding and administer the next feeding due in 6 hours

9.) When inserting an indwelling urinary catheter in a male patient, the nurse cleanses the penis with an antiseptic wash. Which step should she take next?

• Gently insert the tip of the prefilled syringe into the urethra to install the lubricant.
• Ask the patient to bear down a though trying to avoid.
• Slowly insert the end of the catheter into the urinary meatus.
• Insert the catheter about 7 to 9 (17 to

10.) A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is scheduled for cardiac catheterization. Which medication would need to be withheld for 24 hours before the procedure and for 48 hours after the procedure?

• Regular insulin
• Glipizide (Glucotrol)
• Repaglinide (Prandin)
• Metformin (Glucophage)

11.) A 52-year old female patient is receiving medical treatment for a possible tuberculosis infection.The patient is a U.S. resident but grew-up in a foreign country. She reports that as a child she received the BCG vaccine (bacilli Calmette-Guerin vaccine). Which physician’s order below would require the nurse to ask the doctor for an order clarification?

• PPD (Mantoux test)
• Chest X-ray
• QuantiFERON-TB Gold (QFT)
• Sputum culture

12.) You are assessing your newly admitted patients who are all representing with atypical signs and symptoms of a possible tuberculosis. So, therefore, the patients are being monitored and tested for the disease. Select all the risk factors below that increases a patient’s risk for developing

tuberculosis:

• Diabetes
• Liver failure
• Long-term care resident
• Inmate
• IV drug user

6. HIV

• U.S. resident

13.) You’re helping a mother, whose child was recently diagnosed with Celiac Disease, read food labels. Which items below, if listed as the ingredients, should the mother avoid feeding her child?

• Millet
• Wheat
• Malt
• Corn
• Buckwheat
• Rye

14.) During an outpatient clinic visit, a female patient reports feeling abdominal bloating/pain, and diarrhea when eating foods that contain wheat or rye. The patients states her mother was diagnosed with Celiac Disease 5 years ago. What other symptoms will you assess the patient for that can be

present in Celiac Disease? SELECT-ALL-THAT-APPLY:

• Unexplained Weight loss
• Jelly-like stools
• Mouth ulcers
• Menstrual irregularities
• Pain at McBurney’s Point
• Ribbon-like stools
• Inability to tolerate dairy products
• Enamel changes

15.) How to Ambulate Using Crutches?

• The patient must place the bodyweight on the handgrips, not the rest pad of the crutch,

while ambulating.

• Elbows should be flexed at 30 degrees while holding the grips.
• Start with the tripod position (both legs and crutches in standing position).
• Choose the type of gait depending on the patient’s condition or extremity weakness.

16.) The nurse is preparing to administer medications to a client admitted with atrial fibrillation. The nurse notes the vital signs shown in the exhibit. Which medications due at this time are safe to administer? Select all that apply.Vital signs Temperature 98.4 F (36.9 C) Blood pressure 124/78 mm Hg Heart rate 46/min and irregularly irregular Respirations 22/min

• Diltiazem extended-release PO
• Heparin subcutaneous injection
• Lisinopril PO
• Metoprolol PO
• Timolol ophthalmic

17.) A 45-year-old client with atrial fibrillation has been prescribed diltiazem. Which client outcome would best indicate that the medication has had its intended effect?

• Atrial fibrillation is converted to sinus rhythm
• Blood pressure is 126/78 mm Hg
• No signs or symptoms of stroke
• Ventricular rate decreased from 158/min to 88/min

18.) The registered nurse (RN) is discussing care of shared clients with the licensed practical nurse.Which of the following clients require intervention by the RN? Select all that apply.

• A client receiving a blood transfusion who reports severe anxiety and has blood pressure 90/60

mm Hg and pulse 110/min

• A client receiving oral metoprolol whose heart rate has decreased to 60/min after administration
• A client whose blood pressure decreased from 130/80 mm Hg to 110/70 mm Hg following

administration of 1 mg hydromorphone IV

• A client whose blood pressure was 90/65 mm Hg before prescribed oral nifedlipine was

administered

• A client whose pulse increased from 70/min to 100/min after albuterol administration

19.) A client is admitted to the cardiac care unit with atrial fibrillation. Vital signs are shown in the exhibit. Which prescription should the nurse perform first?

• Administer diltiazem 20 mg IVP
• Administer rivaroxaban 20 mg PO
• Draw blood for a thyroid function test
• Send the client for echocardiogram

20.) A patient is prescribed Metoprolol. Which statement by the patient requires the nurse to re- educate the patient on how to take the medication properly?

• “After I stop taking this medication I will let my physician know.”
• “I take this medication with my breakfast every morning.”
• “I will change positions slowly while I’m taking this medication.”
• “While I’m taking this medication I will monitor my heart rate.”

21.) What sign and symptoms below would demonstrate a patient is experiencing an overdose of a

beta blocker medication? Select all that apply:

• Blood pressure 200/110
• Heart rate 35 beats per minute
• EKG shows atrial fibrillation with rapid ventricular rate (RVR)
• Patient is maniac and agitated
• Dyspnea
• Patient is severely drowsy
• EKG shows 3

rd degree AV block

22.) The home health nurse visits a client with atrial fibrillation who is newly prescribed digoxin 0.25 mg orally on even-numbered days. Which of the following client statements show that teaching has been effective? Select all that apply.

• “I need to call the health care provider (HCP) if I have trouble reading.”
• “I need to check my blood pressure before taking my medicine.”
• “I should call the HCP if I develop nausea and vomiting.”
• “I should check my heart rate prior to taking this medication.”
• “I will call the HCP if I feel dizzy and lightheaded.”