50 mL/hr 25 mL/hr 75 mL/hr 15 mL/hr
The nurse is assessing for abdominal pulsations in a client with a visible mass below the umbilicus. The nurse should use which technique?
light palpation inspection percussion deep palpation
A nurse assessing a client charts his blood pressure as 134/86. The pulse pressure would be
48. 86. 220. 96.
A nurse has been hired by a company to educate employees on health risks. Which of the following may suggest substance abuse by certain employees in the workplace?
frequent call-ins and tardiness taking only the allocated two 15-minute breaks per shift increasingly poor performance evaluations meeting coworkers for dinner after work eating lunch alone at the desk instead of in the breakroom
A post-operative client with an abdominal wound tries to reach over and take a book off the bedside table. He immediately screams and calls for the nurse. The nurse notices serosanguineous drainage coming from the incision on the abdomen. The first action the nurse should take is to
cover the incision with a sterile cloth or dressing. lower the head of the bed to less than 10 degrees. check the client’s vitals to assess for drop in blood pressure. call and alert the surgeon.
A child with a known peanut allergy is eating lunch at summer camp and develops an anaphylactic reaction from accidentally ingesting peanut butter–flavored cookies. The nurse’s first intervention should be to
have the child lie down on the ground. take the child’s blood pressure. verify the child has stopped eating and has no more cookies in his mouth. ask the child how many cookies he ate.
The nurse is caring for a laboring client who is on an oxytocin infusion. The client experiences seven contractions in a 10-minute time period. The fetal heart rate tracing is a category III. Which action should the nurse take?
discontinue the oxytocin infusion increase the oxytocin infusion rate decrease the oxytocin infusion rate by half reposition the client into a high-Fowler’s position
The nurse is caring for a client diagnosed with glaucoma. The health care provider has ordered timolol maleate. Which finding in the client’s history would prompt the nurse to notify the health care provider?
asthma migraines atrial fibrillation urinary tract infection
The nurse is reviewing labs for a client whose potassium level is 5.3 mEq/L. Which order should the nurse anticipate from the health care provider?
an order for K-Dur an order for Pradaxa an order for Namenda an order for Kayexalate
A student nurse is assigned to care for a client in a protective environment room. The nurse knows to intervene upon observing which of the following deliveries by the nursing student?
indwelling catheterization kit flower bouquet tray of food containing disposable plate and utensils oral medication