CMS_yetty_questions.doc

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1 A nurse is assessing for early signs of compartment syndrome for a client who has a short-leg fiberglass cast. Which of the following findings should the nurse expect? A. Capillary refill less tha... n 2 seconds B. Bounding distal pulses C. Intense pain with movement D. Erythema of the toes 2 A nurse is monitoring a client who is receiving 2 units packed RBCs. Which of the following manifestations indicates a hemolytic transfusion reaction? A. Chills ? (think fever, you get cold when your body is hot) B. Hypertension C. Bradycardia D. Back pain 3 A nurse is caring for a client who had a total hip arthroplasty. Which of the following actions should the nurse take to prevent hip dislocation? A. Remove the wedge device when turning B. Place two bed pillows between the legs when in bed C. Encourage the client to lean forward when attempting to stand D. Elevate the knees higher than the hips when sitting 4 A nurse is assessing a client who is preoperative and reports an allergy to bananas. The nurse should recognize that the client is at risk for an allergic cross-reactivity to which of the following substances A. Povidone-iodine B. Adhesive tape C. Latex D. Anesthetics 5 A nurse is teaching a client about the use of an incentive spirometer. Which of the following instructions should the nurse include in the teaching? A. Place hands on the upper abdomen during inhalation. B. Position the mouthpiece 2.5 cm (1 in) from the mouth C. Exhale slowly through pursed lips D. Hold breaths about 3 to 5 seconds before exhaling 6 A nurse is caring for a client who arrives at the emergency department and reports vomiting and diarrhea for the past 3 days. The client’s serum potassium level is 2.8mEq/L. Which of the following interventions should the nurse implement first? Priority question remember, what can I do first, you can start a K+ drip without knowing how their heart is affected. A. Check the clients hand grasps B. Administer an IV potassium drip C. Listen to the client’s bowel sounds D. Initiate cardiac monitoring for the clients This is a priority!!! 7 A nurse is preparing to administer peritoneal dialysis to a client. Which of the following actions should the nurse take? A. Chill the dialysate before administration B. Hang the drainage bag below the client’s abdomen C. Place the client in high-Fowlers position D. Use clean technique to access the catheter 8 A nurse is preforming a cranial nerve assessment on a client following a head injury. Which of the following findings should the nurse expect if the client has impaired function of the vestibulocochlear nerve (cranial nerve VIII)? A. Inability to smell B. loss of peripheral vision C. Disequilibrium with movement D. Deviation of the tongue from midline 9 A nurse is planning care for a client who is one day postoperative Following an open cholecystectomy. Which of the following interventions should the nurse include in the plan of care? A. Place pillows under the clients knees B. Avoid use of anticoagulants C. Discourage leg exercises while in bed D. apply compression stockings to the lower extremities 10 A nurse is caring for a male client who has an exacerbation of heart failure. Which of the following prescriptions should the nurse expect to receive from the provider? (click on the “exhibit” button for additional information about the client. There are 3 tabs that contain separate categories of data.) A. Atropine 1mg IV bolus every 5 min up to 3 mg ? B. Adenosine 6mg rapid IV bolus n [Show More]

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