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EVOLVE COMPREHENSIVE EXAM Questions and Answers Latest Updates 2024 GRADE A+, Exams of Nursing

University of Birmingham Nursing

EVOLVE COMPREHENSIVE EXAM Questions and Answers Latest Updates 2024 GRADE A+

Typology: Exams

2023/2024

Available from 08/19/2024

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EVOLVE COMPREHENSIVE EXAM

Questions and Answers

Latest Updates 2024

GRADE A+

1. A client with asthma receives a prescription for high blood pressure during

a clinic visit. Which prescription should the nurse anticipate the client to

receive that is at least likely to exacerbate asthma?

Correct answer- Metoprolol Tartrate( Lopressor)

The best antihypertensive agent for clients with asthma is metoprolol

(Lopressor) (C), a beta2 blocking agent which is also cardioselective and

less likely to cause bronchoconstriction. Pindolol (A) is a beta2 blocker

that can cause bronchoconstriction and increase asthmatic symptoms.

Although carteolol (B) is a beta blocking agent and an effective

antihypertensive agent used in managing angina, it can increase a

client's risk for bronchoconstriction due to its nonselective beta blocker

action. Propranolol (D) also blocks the beta2 receptors in the lungs,

causing bronchoconstriction, and is not indicated in clients with asthma

and other obstructive pulmonary disorders.

2. A male client who has been taking propranolol ( inderal) for 18 months

tells the nurse the healthcare provider discontinued the medication

because his blood pressure has been normal for the past three months.

Which instruction should the use provide?

Correct answer- Ask the health care provider about tapering the drug

dose over the next week.

Although the healthcare provider discontinued the propranolol, measures

to prevent rebound cardiac excitation, such as progressively reducing the

dose over one to two weeks (C), should be recommended to prevent

rebound tachycardia, hypertension, and ventricular dysrhythmias. Abrupt

cessation (A and B) of the beta-blocking agent may precipitate

Partial preview of the text

Download EVOLVE COMPREHENSIVE EXAM Questions and Answers Latest Updates 2024 GRADE A+ and more Exams Nursing in PDF only on Docsity!

EVOLVE COMPREHENSIVE EXAM

Questions and Answers

Latest Updates 2024

GRADE A+

A client with asthma receives a prescription for high blood pressure during a clinic visit. Which prescription should the nurse anticipate the client to receive that is at least likely to exacerbate asthma? Correct answer- Metoprolol Tartrate( Lopressor) The best antihypertensive agent for clients with asthma is metoprolol (Lopressor) (C), a beta2 blocking agent which is also cardioselective and less likely to cause bronchoconstriction. Pindolol (A) is a beta2 blocker that can cause bronchoconstriction and increase asthmatic symptoms. Although carteolol (B) is a beta blocking agent and an effective antihypertensive agent used in managing angina, it can increase a client's risk for bronchoconstriction due to its nonselective beta blocker action. Propranolol (D) also blocks the beta2 receptors in the lungs, causing bronchoconstriction, and is not indicated in clients with asthma and other obstructive pulmonary disorders.
A male client who has been taking propranolol ( inderal) for 18 months tells the nurse the healthcare provider discontinued the medication because his blood pressure has been normal for the past three months. Which instruction should the use provide? Correct answer- Ask the health care provider about tapering the drug dose over the next week. Although the healthcare provider discontinued the propranolol, measures to prevent rebound cardiac excitation, such as progressively reducing the dose over one to two weeks (C), should be recommended to prevent rebound tachycardia, hypertension, and ventricular dysrhythmias. Abrupt cessation (A and B) of the beta-blocking agent may precipitate

tachycardia and rebound hypertension, so gradual weaning should be recommended.

A client who is taking clonidine ( Catapres, Duraclon) reports drowsiness. Which additional assessment should the nurse make? Correct answer- How long has the client been taking the medication Drowsiness can occur in the early weeks of treatment with clonidine and with continued use becomes less intense, so the length of time the client has been on the medication (A) provides information to direct additional instruction. (B, C, and D) are not relevant.
The nurse is preparing to admister atropine, an anticholinergic, to a client who is scheduled for a cholecystectomy. The client asks the nurse to explain th reason for the prescribed medication. What response is best for the nurse to provide? Correct answer- Decrease the risk of bradycardia during surgery Atropine may be prescribed preoperatively to increase the automaticity of the sinoatrial node and prevent a dangerous reduction in heart rate (B) during surgical anesthesia. (A, C and D) do not address the therapeutic action of atropine use perioperatively.
An 80 year old client is given morphine sulphate for postoperative pain. Which concomitant medication should the nurse question that poses a potential development of urniary retention in this geriatric client.? Correct answer- Tricyclic antidepressants Drugs with anticholinergic properties, such as tricyclic antidepressants (C), can exacerbate urinary retention associated with opioids in the older client. Although tricyclic antidepressants and antihistamines with opioids can exacerbate urinary retention, the concurrent use of (A and B) with opioids do not. Nonsteroidal antiinflammatory agents (D) can increase the risk for bleeding, but do not increase urinary retention with opioids (D).
The nurse obtains a heart rate of 92 and a blood pressure of 110/76 prior to administering a scheduled dose of verapamil (Calan) for a client with atrial flutter Which action should the nurse implement? Correct answer- Admister the dose as prescribed Verapamil slows sinoatrial (SA) nodal automaticity, delays atrioventricular (AV) nodal conduction, which slows the ventricular rate, and is used to treat atrial flutter, so (A) should be implemented, based on the client's

a client who has active tuberculosis ( TB) is admitted to the medical unit. What action is most important for the nurse to implement? Correct answer- Assign the client to a negative air-flow room Active tuberculosis requires implementation of airborne precautions, so the client should be assigned to a negative pressure air-flow room (D). Although (A and C) should be implemented for clients in isolation with contact precautions, it is most important that air flow from the room is minimized when the client has TB. (B) should be implemented when the client leaves the isolation environment.
A client is receiving atonal (tenormin) 25 mg PO after a myocardial infraction. The nurse determines the clinents apical pulse is 65 beats per minute. What action should the nurse implement next? Correct answer- Administer the medication Atenolol, a beta-blocker, blocks the beta receptors of the sinoatrial node to reduce the heart rate, so the medication should be administered (C) because the client's apical pulse is greater than 60. (A, B, and D) are not indicated at this time.
A 6 year old child is alert but quiet when brought to the emergency center with periobital ecchymosis and ecchymosis behind the ears. The nurse suspects potential child abuse and continues to assess the child for additional manifestations of a basilar skull fracture. What assessment finding would be consistent with the basilar skull fracture? Correct answer- Rhinorrhoea or otorrhoea with halo sign Raccoon eyes (periorbital ecchymosis) and Battle's sign (ecchymosis behind the ear over the mastoid process) are both signs of a basilar skull fracture, so the nurse should assess for possible meningeal tears that manifest as a Halo sign with CSF leakage from the ears or nose (D). (A) is consistent with orbital fractures. (B) occurs with wrenching traumas of the shoulder or arm fractures. (C) occurs with blunt abdominal injuries.
The nurse is assessing a client who complains of weight loss, racing heart rate and difficulty sleeping. The nurse determines the client has moist skin with fine hair, prominent eyes, lid retrace, and a staring expression. These findings are consistent with which disorder? Correct answer- Graves disease This client is exhibiting symptoms associated with hyperthyroidism or Grave's disease (A), which is an autoimmune condition affecting the thyroid. (B, C, and D) are not associated with these symptoms.

The nurse is assessing an older adult client and determines that the client's left upper eyelid droops, covering more of the iris than the right eyelid. Which description should the nurse use to document this finding? Correct answer- Ptosis on the left eyelid Ptosis is the term to describe an eyelid droop that covers a large portion of the iris (A), which may result from oculomotor nerve or eyelid muscle disorder. (B) is characterized by rapid, rhythmic movement of both eyes. (C) is a distortion of the lens of the eye, causing decreased visual acuity. (D) is a term used to describe a protrusion of the eyeballs that occurs with hyperthyroidism.
The nurse obtains the pluse rate of 89 beats/min for an infant before administering digoxin (Lanoxin) which action should the nurse take? Correct answer- Withhold the medication and contact the healthcare provider Bradycardia is an early sign of digoxin toxicity, so if the infant's pulse rate is less than 100 beats/minute, digoxin should be withheld and the healthcare provider should be notified (D). Assessing the respiratory rate (A) is not indicated before administering Lanoxin. (B and C) place the infant at further risk for digoxin toxicity.
The nurse is developing a teaching plan for an adolescent with a milwaukee brace. Which instruction should the nurse include? Correct answer- Wear the brace over a T-shirt 23 hours a day. Idiopathic scoliosis is an abnormal lateral curvature of the spine in adolescent females. Early treatment uses a Milwaukee brace that places pressure against the lateral spinal curvature, under the neck, and against the iliac crest, so it should be worn for 23 hours per day over a T-shirt (D) which reduces friction and chafing of the skin. (A, B, and C) reduce the effectiveness of the brace.
A 9 year old is hospitalized for the neutropenia and is placed in reverse isolation. The child asks the nurse " why do you have to wear a gown and mask when you are in my room?" How should the nurse respond? Correct answer- " To protect you because you can get an infection very easily Reverse isolation precaution implement measures to protect the client from exposure to microorganisms from others (B). Although microbes are prevalent in all environments, (A) does not adequately answer the child's

fetus. A radiation exposure decreases the immune response in the client who should not be exposed to the potential inadvertent transmission of an infectious organism (D).

Which info should the nurse provide a client who has undergone cryrosyrgery for stage 1A cerviacl cancer? Correct answer- Use a sanitary napkin instead of a tampon. Clients should avoid the use of tampons for 3 to 6 weeks (D) after the procedure to reduce the risk of infection. A heavy, watery vaginal discharge is expected during this time, so (A) is unnecessary. Sexual intercourse should be avoided for up to 6 weeks, so (B) is inaccurate. (C) is not a side effect of the procedure but may indicate human papillomavirus or a cancerous lesion and should be reported.
the nurse is preparing a client for schedules surgical procedure. What client statement should the nurse report to the healthcare provider.? Correct answer- Recalls drinking a glass of juice after midnight. Because there is a risk of aspiration while under general anesthesia The risk of aspiration while under general anesthesia is increased when the stomach is not empty prior to a surgical procedure, so the client's intake of juice (B) after midnight should be reported the healthcare provider. Preoperative fear and anxiety (A) are common and should be further explored by the nurse. (C) should be communicated using allergy identification tags on the client's records and bracelets on the client's wrist. (D) is a common and expected side effect of perioperative medications.
The nurse determines that a clients body weight is 105A% above the standardized height-weight scale. Which related factor should the nurse include in the nursing problem, " Imbalanced nutrition: More than body requirements? " Correct answer- Inadequate lifesyle changes in diet and exercise Obesity is a body weight that is 20% above desirable weight for a person's age, sex, height, body build, and calculated body mass index (BMI). (C) best identifies factors that contribute to the formulation of the nursing diagnosis. (A and B) are medical classifications for a client's weight. Although the client is at an increased risk for several chronic illnesses (D), such as heart disease, diabetes mellitus, hypertension, coronary artery disease and hyperlipidemia, this is not a contributing cause or related factor that supports the nursing diagnosis.

The nurse is inspecting the external eye structures for a client. Which finding is a normal racial variation? Correct answer- An African-American Client may have slightly yellow sclerae. Recognizing normal variations that are common in different racial groups helps the nurse differentiate an early sign of pathology, such as yellow sclerae. A slightly yellow color of the sclera for (C) is a normal racial variation found in the African-American population. (A, B, and D) are findings not related to one racial group.
During the physical assessment, which finding should the nurse recognize as a normal finding? Correct answer- Regular pulsation at the epigastric area when the client is supine. Recognizing normal findings in the physical exam is a necessity. The regular and recurrent expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle as it contracts is a normal finding (A). (B, C, and D) are abnormal findings that require further assessment.
When documenting assessment data, which statement should the nurse record in the narrative nursing notes? Correct answer- S1 Murmur auscultated in supine position. Documentation of subjective and objective data obtained from the physical assessment should be communicated using precise, descriptive, clear, and accurate information, such as auscultated heart sounds while the client is in a specified position (C). (A, B, and D) are nonspecific.
A female client reports to the nurse that her sleep was interrupted by " thoughts of anger towards my husband" What type of thoughts is the client having? Correct answer- Obsessive Obsessive thoughts (A) are thoughts that the client is unable to control. (B) are irrational fears. (C) are false beliefs. (D) are suspicious thoughts
The nurse attempts to notify the healthcare provider about a client who is exhibiting an extrapyramidal reaction to psychotropic medications. When the receptionist for the answering service offers to take a message , which nursing action is best for the nurse to take? Correct answer- Tell the receptionist to have the healthcare provider return the phone call.

A work group is to be formed to determine a care map for a new surgical intervention that is being conducted at the hospital. Which group is likely to besot effective in developing the new care map? Correct answer- Multisicipilinary group In a multidisciplinary work group (B), a number of individuals from a variety of disciplines are involved in developing the care map, but each works independently to implement the care plan. Single-discipline work groups (C), such as (A or D), are likely to focus on the aspects of the care map related only to their specific discipline.
The scope of professional nursing practice is determined by rules promulgated by which organization.? Correct answer- State's board of nursing The state's Board of Nursing (A) is authorized to promulgate rules and regulations that carry the weight of law. The State Legislature delegates its law-making authority to this administrative law body. (B and C) are influential in defining and describing nursing standards of care, but neither have the authority to pass laws that legally define the professional scope of nursing practice. Although (D) may rule on issues important to nursing practice, the scope of professional nursing practice is determined by the laws, rules, and regulations promulgated by state Boards of Nursing.
An older client who has been bedridden for a month is admitted with a pressure ulcer on the left trochanter area. The nurse determines that the ulcer extends into the subcutaneous tissue. At which stage should the nurse document this finding? Correct answer- Stage 3 Pressure ulcers develop over skin surfaces usually covering bony prominences and are caused by external pressure that impedes blood flow, causing ischemia of the skin and underlying tissue. The stage of the pressure area is determined by the depth of tissue damage, and this client's lesion should be documented as a Stage 3 (C) because it is a full thickness tissue loss with visible subcutaneous fat that does not expose bone, tendon, or muscle. (A) is a nonblanchable pressure point over intact skin. (B) is a partial thickness ulcer, such as a ruptured blister or shallow open ulcer with a pink wound bed. (D) is a full thickness tissue loss with exposed bone, tendon or muscle, slough or eschar, and often includes undermining and tunneling.
When meeting with the client and the family, which nursing intervention demonstrates the nurses role as collaborator of care?

Correct answer- Coordinating and educating about multidisciplinary services Clinical decisions to achieve client outcomes require collaborative efforts between the interdisciplinary team and the client-family cooperation. The nurse's role as collaborator of care is best displayed by coordinating and educating the client and family about multidisciplinary services (A). Information about financial assistance programs (B) is most often a role of social services. Although the nurse refers and consults with the healthcare team (C), client-focus care is best identified within a collaborative nurse- client-family relationship. Informing the client about a clinical diagnosis (D) is the responsibility of the healthcare provider.

Preoperatively, a client is to receive 75mg of meperidine (demerol) IM. The Demerol solution contains 50 mg/mL. How much solution should the nurse administer? Correct answer- 1.5 mL To correctly solve this problem, use the formula: Desired/On Hand, or the algebraic formula: 75: x = 50 : 1. 50x = 75. x = 75/50 or reduced to 1.5 mL (C).
A low potassium diet is prescribed for a client what foods should the nurse try to avodi? Correct answer- Dried prunes A serving of dried prunes (D) contains more than 300 mg of potassium, and should be avoided. The richest dietary sources of potassium are unprocessed foods (especially fruits), many vegetables, and some dairy products, so the client should avoid these food groups. Servings of foods containing less than 150 mg of potassium, such as (A, B, and C), are good choices for a low potassium diet.
A client is admitted with a medical diagnosis of addisonian crisis. When completing the admission assessment, the nurse expects this client to exhibit which clinical manifestations? Correct answer- Hypotension, rapid weak pulse, and rapid respiratory rate The clinical manifestations of Addisonian crisis are often the manifestations of shock (C); the client is at risk for circulatory collapse and shock. (A) indicates clinical manifestations of Cushing's syndrome, (B) of pheochromocytoma (tumor of adrenal medulla), and (D) of thyroid storm (thyrotoxic crisis).

opportunity to take control of the problem and use problem solving techniques to resolve the situation. (B) may be offering false reassurance.

The nurse is teaching staff in a long term - facility home the principles of caring for clients with essential hypertension. Which comment should the nurse include in the inservice presentation about the care of clients with hypertension? Correct answer- Frequent blood pressure checks, including readings taken automated machines are recommended Frequent blood pressure checks (D) are recommended for hypertensive clients to evaluate the effectiveness of treatment. Symptoms such as (A) are not typical of essential hypertension, which is an asymptomatic disease. Treatment (B) usually includes dietary modifications and exercise, which should not be discontinued when medications are added to the treatment plan. While the RN is ultimately responsible for the assessment of blood pressures (C), caregivers are not restricted from obtaining the blood pressure readings.
A client is admitted to the hospital for alcohol dependency. What is the priority nursing intervention during the first 48 hours following admission? Correct answer- Monitor for increased blood pressure and pulse Clients with alcohol dependency experience withdrawal symptoms, which include elevated blood pressure, pulse, and temperature, so (B) has the highest priority. (A) will prevent Korsakoff's syndrome (secondary dementia caused by thiamine deficiency, associated with malnutrition secondary to excessive alcohol intake), but this intervention does not have the priority of (B). (C and D) are important for alcohol detoxification, but do not have the priority of (B).
A male client diagnosed with antisocial personality disorder is morbidly obese and is placed on a low fat diet,low calorie diet. At dinner the nurse notes that he is trying to get other clients on the unit to give him part of their meals. what intervention should the nurse implement? Correct answer- Confront the client about the consequences of the behavior. The nurse should provide a reality check by helping the client realize that there are consequences to his behavior (D). (A and B) do not help the client realize that his behavior is manipulative and harmful to himself as well as others. This behavior needs to be documented, but (C) does not need to be implemented.

A child with tetrology of ballot suffers a hyper cyanotic episode. Which immediate action by the nurse can lessen the symptoms of this " TET" spell? Correct answer- Place child in knee-chest positionThis pressure reduces the rush of blood flow through the septal hole and improves blood circulation. The child should be placed on his or her back in the knee-to-chest position (B) to increase blood vessel resistance. The increased pressure reduces the rush of blood through the septal hole and improves blood circulation. (A) has nominal effects in hypercyanosis. (C) is self-regulating. (D) is not indicated for immediate relief of tet spells. It is used to improve cardiac output.
A client with metastatic cancer is preparing to make a decisions about end-of-life issues. When the nurse explains a durable power of attorney for health care, which description is accurate? Correct answer- It will identify someone that can make the decisions for you health care if you are ever in a coma or vegetative state. This is a legal document that allows individuals to identify someone to make decisions for health care, identifies how aggressive treatment should be if the client should ever be in a coma or persistent vegetative state, and lists any medical treatments they would never want performed (B). (A) is the definition of the "Living Will"; some states and Canada do not consider Living Wills legal documents. A durable power of attorney is a legal document (C), and it is not a hospital form (D).
After eye drops are instilled, which instruction should the nurse provide to the client? Correct answer- Close your eyelids Gently closing the eyelids (C) without blinking (D) allows the medication to spread over the eye. It is usually helpful for the client to tilt their head back (A) while the eye drops are being instilled. (B) will not assist in medication distribution or absorption.
the nurse is preparing to administer IV fluid to a client with strict fluid restriction. IV tubing with which feature is most important for the nurse to select? Correct answer- A Buretrol Attachment A buretrol attachment is used to restrict the total volume of IV fluids that a client receives (D). (A and B) control the rate of administration, but not the

PKU screening is mandatory in most states and requires that the newborn has ingested adequate amounts (2 to 3 days) of milk proteins (C) to detect metabolism errors, which result in abnormal phenylalanine (an amino acid) in the newborn's blood and predisposes the infant to mental retardation. (A and D) are not necessary. (B) is commonly practiced when infants are discharged at 24-hours of age or before adequate milk proteins have been ingested.

which nursing intervention is an example of a competent preformance criterion for an occupational and environmental health nurse? Correct answer- Implements health programs for construction workers Implementing health programs for construction workers (B) is an example of a competent performance criterion in management, which includes monitoring of the quality and effectiveness of vendor services. (A) is an example of an expert performance criterion for case management. (C and D) are examples of a proficient performance criteria for management.
A client is being admitted to the medical unit form the emergency department after having a chest tube inserted. What equipment should be brought to this client's room? Correct answer- Rubber-tipped clamps Rubber-tipped clamps (C) should be kept at the client's bedside for assessment of possible chest tube air leaks, with the prescription of the healthcare provider. (A), used during a respiratory or cardiac arrest, does not need to be brought to the client's room as a routine precaution. (B) is used to intubate a client and is not indicated for routine care of the client with a chest tube. (D) is indicated by the client's oxygen saturation or arterial blood gases, and is not routinely placed in the room of a client with a chest tube.
The nurse identifies bright-red drainage about 6 cam in diameter, on the dressing of a client who is one day post abdominal surgery. Which action should the nurse take next?? Correct answer- Mark the drainage on the dressing and take vital signs Drainage on a surgical dressing should be described by type, amount, color, consistency, and odor, and the surgeon should be notified of any excessive or abnormal drainage and significant changes in vital signs. To determine that the drainage on an abdominal surgical dressing is usual and not an indication of hemorrhage, marking the 6 cm drainage on the

dressing (A) assists in determining an increase in the amount which is supported with any changes in vital signs that indicates possible internal bleeding. (B) is premature. Removing the initial dressing may disturb the surgical site and increase the risk of hemorrhage and infection (C). (D) is compared with the previous amount of drainage marked on the dressing, so (A) is necessary.

The nurse is planning care for a client who is having abdominal surgery. To achieve postoperative outcomes, the nurse includes interventions that promote progressive mobilization, such a turn, cough, deep breathe, and early ambulation. Which additional intervention should the nurse include? Correct answer- Administer analgesics prior to encouraging progressive activities and ambulation Effective pain management in the postoperative period promotes the client's participation in exercises that promote optimal healing and prevent complications, so the client should be given an analgesic prior to mobilization (C). Although (A) promotes client understanding, it is more important that the client's pain is managed to promote cooperation and compliance in the care plan. (B) is helpful but is not as useful if the client is in pain. (D) may unduly scare the client.
Prior to a cardiac cauterization, which activity should the nurse have the client practice? Correct answer- Valsalva's maneuver and coughing Before the cardiac catheterization, the client should practice techniques (e.g., Valsalva's maneuver, coughing, deep breathing) that will be used during the procedure (B). The client should keep the leg straight, not (A), for the prescribed number of hours post cardiac catheterization to prevent bleeding from the arterial access site. (C) is not used in this procedure. The client may be asked to change position during the procedure, so (D) is not necessary.
The nurse is caring for a client who is one day postoperative after a left total knee arthroplasty (TKA) which intervention should the nurse include in the plan of care? Correct answer- Progressive leg exercises to obtain 90-degree flexion Isometric quadriceps setting begins the first day after TKA surgery and progresses to straight-leg raises, then gentle ROM to increase muscle strength until 90-degree knee flexion is obtained (A). Bed rest and immobilization is contraindicated to prevent scar tissue, which limits mobility (C). Active flexion exercises through the use of a continuous

neck, fatigue, and swollen lymph nodes are more typical, not nausea and vomiting (C).

The nurse is planning a teaching program about prenatal care for a diverse ethnic group of clients. Which factor is most influential for the acceptance of the healthcare practices? Correct answer- Individual beliefs The client's beliefs (C) are key to accepting healthcare practices and interventions. Although (A, B, and D) influence an individual's interpretation and acceptance of different healthcare practices, (C) is most influential.
A female client tells the nurse that her home pregnancy test is positive and her last menstrual period (LMP) was febuary 14. the client wants to know the expected date of birth (EDB) how should the nurse respond? Correct answer- November 21 Subract 3 months and add 7 days to the first day of the last normal menstrual period. Using Nägele's rule to calculate EDB, subtract 3 months and add 7 days to the first day of the last normal menstrual period. The client's LMP is February 14, so less 3 months + 7 days is November 21 (B) of the next year. (A, C, and D) are inaccurate.
Two hours after vaginal devilry of a 7-pound 3 ounces infant, a clients fundus is 3 cm above the umbilicus, boggy, and located to the right of midline. Which action should the nurse take first? Correct answer- Palpate above the symphysis for the bladder. Two hours after giving birth, the uterus should be firm, in the midline, and below the umbilicus. If the fundus is high, dextroverted and boggy, urinary retention is likely distending the bladder, so palpating for a full bladder above the symphysis (B) should be implemented first. (A, C, and D) are implemented after the client voids or the bladder is emptied by catheterization.
The clinic nurse identifies an elevation in the results of the triple marker screening test for a client who id in the first trimester of pregnancy. which action should the nurse prepare the client for? Correct answer- Preparing for other diagnostic testing

The triple marker screen measures maternal serum levels for alpha- fetoprotein (AFP), human chorionic gonadotropin (HCG), and estriol, which screens for indications of possible fetal defects. An elevated result may be a false indicator, so other tests are indicated (B). (A) is not necessary or helpful. Elevated results warrant further testing with ultrasound or amniocentesis before initiating (C or D).

Which finding should the nurse idnetify as an early clinical manifestation of neonatal encephalopathy related to hyperbilirubinemia? Correct answer- Lethargy or irritability Hyperbilirubinemia causes severe brain damage, encephalopathy (kernicterus), that results from the deposition of unconjugated bilirubin in brain cells. Prodromal clinical manifestations of central nervous system involvement include decreased activity, a loss of interest in feeding, and lethargy or irritability (C). Without treatment, progressive signs of neurologic damage include (A, B, and D).
Which action should the nurse implement when administering a prescription drug that should be given on an empty stomach? Correct answer- Give one hour before or two hours after a meal When administering a drug on an empty stomach, the drug should be given either one hour before a meal or two hours after a meal (B), which is the average transit time from the stomach to the duodenum after eating. An eight-hour fast is more time than is needed for the stomach to empty (C) and is not necessary. The last time any food or drink has been ingested is a better indicator of an empty stomach, rather than after the client has missed a meal (C). Some liquids, such as grapefruit juice, can alter the drug's dilution and absorption (D).
A male client with a history of chronic back pain that was managed with opiate analgesics calls the nurse after having back surgery. The client reports that the back pain is finally gone, but after stopping the pain medication, the client has been having severe diarrhea and painful muscle cramps. Which assessment information should the nurse obtain next? Correct answer- When did the symptoms begin after the last dose of opiate analgesic? Moderate to severe opiate withdrawal manifests with moderate to severe vomiting, diarrhea, muscle cramps, and elevated blood pressures greater than 110 systolic or 70 diastolic. The onset of withdrawal for opiate analgesics typically coincides with the time of the next habitual drug dose

EVOLVE COMPREHENSIVE EXAM Questions and Answers Latest Updates 2024 GRADE A+, Exams of Nursing

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Partial preview of the text

Download EVOLVE COMPREHENSIVE EXAM Questions and Answers Latest Updates 2024 GRADE A+ and more Exams Nursing in PDF only on Docsity!

EVOLVE COMPREHENSIVE EXAM

Questions and Answers

Latest Updates 2024

GRADE A+