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The nurse is caring for a client who has just had an implantable cardioverter-defibrillator placed following sudden cardiac arrest. teaching items would the nurse provide? Select 2 that apply.
Answers: A – E
A “You may resume driving in 1 week after the insertion site has healed.”
B “Avoid use of your cellular telephone.”
C “Notify the health care provider right away if you receive a shock.”
D “If you feel dizzy or faint, you should drive to the emergency department.”
E “It is important to notify all health care providers about the device.”
Answers: A-D
A yearly ophthalmologic examinations
B initiating antihypertensive therapy for blood pressure over 140/90 mmHg
C drinking 2L water daily
D applying a moisturizer to the feet nightly
>
Question 16 V
FLAG QUESTION
Match the name of the cardiac rhythm with its description.
Name of rhythm
47
00:49:38
Descriptions
Sinus tachycardia
→
Select a choice from list
Atrial fibrillation
Atrial flutter
->
→
Ventricular tachycardia
Ventricular fibrillation
↑
Which part of the penis is surgically removed during a circumcision?
Multiple Choice
O
Root
Shaft
Prepuce
Glans
Select a choice from list
The nurse hears a client who is scheduled to receive radioactive iodine therapy discussing treatment with the client’s partner. W would require the nurse to provide further teaching?
Answers: A-D
A “We shouldn’t share the same toothpaste tube.”
B “I am going to stay 6 feet away from anyone who is pregnant.”
C “It will be necessary to work from home for a month after therapy.”
D “Remind me to flush the toilet two to three times after each use when I am home.”
46
Which statement about the dartos muscle is false?
00:50:33
Multiple Choice
If it is warm, the dartos muscle contracts to help keep the testes cool.
The contraction of the dartos muscle reduces the surface area of the scrotum to reduce heat loss.
The dartos muscle is the smooth muscle wall in the scrotum.
The dartos muscle reacts to temperature changes.
The nurse is teaching a client with angina about acute coronary syndrome. Which client statement indicates understanding?
Answers: A-D
A “I need to tell my wife I’ve had a heart attack.”
B “Because this is temporary, I don’t need medications for my heart.”
C “Angina is a temporary blood flow problem that will resolve.”
D “This is a warning sign and I need to change my lifestyle to prevent a heart attack.”
Which STD is characterized by the growth of warts on the genitals?
Multiple Choice
о
Syphilis
Gonorrhea
HIV
HPV
Which disorder is characterized by tight foreskin that cannot be pulled back over the glans penis?
Multiple Choice
Phimosis
Hypospadias
Hydrocele
Cryptorchidism
Table 26.1
Wells Criteria/Modified Wells Criteria for Predicting Probability of PE
Answers: A-D
A 1
B 1.5
C 4.5
D 8
Answers: A-D
A Within normal limits
B Indicative of type 1 diabetes mellitus
C Confirmation of type 2 diabetes mellitus
D Reflects prediabetes mellitus
During which stage of the sexual response do the bulbourethral glands secrete their lubricating fluid?
Multiple Choice
O
Emission
о
Ejaculation
O Resolution
O
Arousal
1:35
Answers: A-D
A A decrease in intracranial pressure
B Thrombocytopenia
C An increase in Glasgow Coma Scale (GCS) score
D Leukocytosis
What process in meiosis involves random alignment of chromosomes?
Multiple Choice
Mitosis
Independent assortment
Meiosis II
Crossing over
During which stage of the sexual response are sperm moved by peristaltic contractions through the vas deferens?
Multiple Choice
Emission
Resolution
Ejaculation
Arousal
Question 10 V
FLAG QUESTION
Name the rhythm shown below.
Гликлиникиикийники
мимимимимимимим
иш
29
Which part of the penis has a lot of nerve endings for sexual stimulation?
Multiple Choice
о Glans
о
о
Root
Shaft
Prepuce
What must happen for male reproductive anatomy to develop?
Check All That Apply
The zygote must have an X and a Y chromosome.
Testosterone must be produced by the developing gonads in the fetus.
The X chromosome must have an SRY gene.
Testosterone must be produced in childhood.
Both sex chromosomes must have an SRY gene.
Which gland surrounds the urethra just below the urinary bladder?
Multiple Choice
Seminal vesicle
O Cowper’s gland
Prostate gland
Bulbourethral gland
Multiple small first-degree burns
Elevated heart rate
BMI 27.1
Decrease in metabolism
Groaning
History of metabolic syndrome
Temperature of 100.6°F (38.2°C)
Almost 50% TBSA burned
Diabetic ketoacidosis
Hyperosmolar hyperglycemic state
Fluid volume deficit
Hyperthermia
1305: Remaining clothing and jewelry removed; large-bore IV inserted; extremities elevated. Client groaning. Burns
assessed and noted:
⚫Anterior and posterior right arm-second and third degree
Half of anterior and posterior trunk-second and third degree Anterior and posterior of both legs-second and third degree
Half of face (right side) and back of head (right side)-second degree
Left side of face and head, and left arm-multiple small areas, first degree
Estimated percent of body burned: 49.5% per rule of nines
Complete the following sentence(s) by selecting from the lists of options below.
The client is at high risk for 1 as evidenced by
and
The nurse cares for a 40-year-old client brought to the emergency department, documents interventions that were instituted at 1 findings.
Health History
Nurses‘ Notes
Vital Signs
Laboratory Results
1300: Brought to emergency department by squad after experiencing second- and third-degree burns. Following the rescue
of his family from a house fire, client returned into the burning house to attempt to rescue a pet. Health history is unremarkable with the exception of metabolic syndrome for which he takes metformin 500 mg twice daily, and high cholesterol for which he takes simvastatin 20 mg at bedtime. Works in sales department of home contractor. Height: 72 inches (183 cm); weight: 200 lb (90.7 kg). VS: T 100.6°F (38.2°C); HR 120 beats/min; RR 26 breaths/min; BP 98/60 mm Hg; SpO2 88% on RA.
1305: Remaining clothing and jewelry removed; large-bore IV inserted; extremities elevated. Client groaning. Burns
assessed and noted:
Answers 1-3
1. Select answer choice
2. Select answer choice
Which of the following statements about a sperm is correct?
Multiple Choice
O
A sperm has an acrosome cap for energy.
O
A sperm contains abundant cytoplasm.
O
A sperm contains 46 chromosomes.
A sperm has large mitochondria to produce ATP.
The nurse is caring for a 48-year-old male client who presents to the emergency department with reports of chest pain. Select whether the following potential nursing actions are indicated or not indicated for this client at this time.
Potential Nursing Actions
Place on continuous heart monitor.
Apply continuous pulse oximetry..
Prepare for cardiac catheterization.
Administer aspirin.
Administer metformin.
Maintain strict bed rest.
Apply oxygen 2 L per nasal cannula to maintain saturation greater than 90%.
Indicated Not Indicated
O
O
12
Which statements about the spermatic cord are true?
01:06:46
Check All That Apply
The pampiniform plexus delivers blood to the testis.
Testicular arteries form a network of vessels around the ductus deferens.
The ductus deferens travels through the inguinal canal.
The testicular artery travels through the inguinal canal.
The dartos muscle in the spermatic cord contracts to draw the testes closer to the body.
Why is norepinephrine an effective medication in treating patients with shock?
Answers: A-D
A It increases perfusion to nonvital organs, such as the GI tract, skin and kidneys.
B It improves cardiac output by increasing the contractility of the heart.
C It increases mean arterial pressure by causing vasoconstriction and increasing venous return.
D It increases the patient’s immune response.
Semen includes which of the following?
Multiple Choice
Secretions from the prostate and urethra
O
Secretions from the prostate, seminal vesicles, and bulbourethral glands
O
Secretions from the prostate, epididymis, and urethra
Secretions from the prostate and epididymis
Which of the following substances is responsible for the development of secondary sex characteristics?
Multiple Choice
Gonadotropin-releasing hormone
Follicle-stimulating hormone
O
Androgen-binding protein
O
Testosterone
Luteinizing hormone
27
Answers: A-D
A “I can take acetaminophen every 4 hours as needed for headache.”
B “I should avoid taking any sedatives or alcohol for at least 24 hours.”
C “I should make an appointment for follow-up with my primary health care provider.”
D “I can go back to work as a construction worker as soon as I get home.”
Sperm travel immediately from the seminiferous tubules to the
Multiple Choice
seminal vesicles
ejaculatory duct
epididymis
O ductus deferens
O efferent ductules
5
While making rounds, the nurse finds a client with type 1 diabetes mellitus pale, sweaty, and slightly confused but able to talk and blood glucose level is 48 mg/dL (2.7 mmol/L). What would be the appropriate nursing action? (Glucose range: 74-106 mg/dL [4.1
Answers: A-D
A
Call the pharmacy and order a STAT dose of glucagon.
B Immediately give the client 30 g of glucose orally.
C Start an IV line and administer a small amount of a concentrated dextrose solution.
Recheck the blood glucose level and call the Rapid Response Team.
Which of the following statements about male reproductive disorders is true?
Multiple Choice
Erectile dysfunction is diagnosed if a male fails to have an erection.
All elevated PSA values indicate prostate cancer.
Cryptorchidism occurs when one or both testes fail to descend into the scrotum.
Testicular cancer is most common in middle-aged white males.
Question 4
FLAG QUESTION
Answers: A – D
A “I will not lay on my left arm while sleeping.”
B “I will not have any IV inserted into my left arm.”
C “I will be able to have the fistula accessed next week for dialysis.”
D “I should be able to feel a pulsation over the site at all times.”
The nurse is planning care for the client who has been diagnosed with atrial fibrillation.
Select whether the following potential nursing actions are indicated or not indicated for the client at this time.
Prompts
Prepare for cardioversion immediately.
Indicated Not Indicated
Assess coagulation status.
Prepare for transesophageal echocardiogram.
Administer atropine per standing order.
о
Keep the client in a supine position with the head of the bed lower than 30 degrees.
Communicate clearly with the client to decrease anxiety.
о
о
1. Select answer choice
2. Select answer choice
Bradycardia
Constipation
Vision impairment
1. Select answer choice
Sleepiness
Exophthalmos
Weight gain
Free T4
3.4 ng/dL (43.8 pmol/L)
3.1 ng/dL (39.9 pmol/L)
2.9 ng/dL (37.3 pmol/L)
0.8-2.8 ng/dL (10-36 pmol/L)
TSH
0.1 pU/mL (0.1 mU/L)
0.2 μU/mL (0.2 mU/L)
0.3 pU/mL (0.3 mU/L)
0.3-5 U/mL (0.3-5 mU/L)
Complete the following sentences by selecting from the list of word choices below. Based on the laboratory findings, the nurse expects that the client will have 1 and
and (2)
Answers 1-2
Serum T4
Females:
14 mcg/dL (180.2 nmol/L)
13 mcg/dL (167.3 nmol/L)
12 mcg/dL (154.5 nmol/L)
5-12 mcg/dL (71-142 nmol/L)
Free T4
3.4 ng/dL (43.8 pmol/L)
3.1 ng/dL (39.9 pmol/L)
2.9 ng/dL (37.3 pmol/L)
0.8-2.8 ng/dL (10-36 pmol/L)
ค
Question 73
FLAG QUESTION
A patient suffers a stroke which results in impaired language comprehension. Which lobe of the brain was affected by the stro
Answers: A – D
A temporal lobe
B occipital lobe
C frontal lobe
D parietal lobe
Question 72
FLAG QUESTION
Which of the following instructions would the nurse provide to a client with type 2 diabetes? Select 2 that apply.
Answers: A – E
A “Avoid all dietary carbohydrates and fat.”
B “Have your eyes and vision assessed by an ophthalmologist every year.”
C “Reduce your intake of animal fat and increase your intake of plant sterols.”
D “Be sure to take your antidiabetic drug before you engage in any type of exercise.”
E “Wearing flip-flops will help to protect your feet when walking long distances.”
The nurse is caring for a client 36 hours after coronary artery bypass grafting. Which assessment causes the nurse to terminate client to bed?
Answers: A-D
A Incisional discomfort
B Urinary frequency
C Respiratory rate 28 breaths/min
D HR 72 beats/min and regular
Answers: A – D
A “When I cough, my chest really hurts.”
B “I had to put a dressing on my sternum because of the drainage.”
C “When I get tired, I just stop and rest for a little while.”
D “My appetite hasn’t been normal since the surgery.”
Question 71 v
FLAG QUESTION
The nurse is caring for a client 36 hours after coronary artery bypass grafting. Which assessment causes the nurse to terminate client to bed?
Answers: A – D
A Incisional discomfort
B Urinary frequency
C Respiratory rate 28 breaths/min
D HR 72 beats/min and regular
An emergency room nurse assesses a patient who was just rescued from a house fire. The patient suddenly develops a loud, bra hoarseness. Which of the following is an appropriate action taken by the nurse?
Answers: A – D
A administer IV labetalol as prescribed
B encourage the patient to use the incentive spirometer
C provide a drink of water
D call a rapid response
The client comes to the emergency department with chest pain and dyspnea. The client states they took nitroglycerin without reli the cardiac monitor and the only electrocardiogram (ECG) change noted is sinus rhythm with T wave inversion. A troponin level is negative, and BNP is within normal limits. Which of the following diagnoses will the nurse anticipate?
Answers: A-D
A ST-elevation myocardial infarction (STEMI)
B Non-ST elevation myocardial infarction (NSTEMI)
C Acute decompensated heart failure
D Pulmonary embolism (PE)
Question 66
FLAG QUESTION
The nurse is caring for a client recently admitted with a left middle cerebral artery embolic stroke. Which of the following assess nurse expect for this client? Select 2 that apply.
Answers: A – E
A Left-sided hemiparesis
B Right-sided tingling and numbness
C Dysarthria
D Ataxia
E Vertigo
The nurse is teaching a client about modifiable risk factors for coronary artery disease (CAD). Which client statement indicates th been effective?
Answers: A-D
A “Vaping does not affect my risk of a heart attack.”
B “Restricting my activity will reduce my risk of CAD.”
C “By losing extra pounds I can reduce my chance of CAD.”
D “It’s in my genes, so there’s nothing I can do to reduce my risk of CAD.”
After stabilization in the emergency department, the client is transferred to a medical-surgical unit for monitoring. The admitting orders ceftriaxone IV every 24 hours in addition to continuing oxygen therapy, performing neurologic checks every 4 hours and b before meals and at bedtime. Several hours after admission, the client’s partner comes to the nurses’ station and reports that th sense when talking. The nurse assesses that the client is sitting in bed, does not make coherent sentences when speaking, and 100.9°F (38.3°C); HR 98 beats/min; RR 22 breaths/min; BP 170/100 mm Hg; SpO2 91% on RA. Fingerstick glucose is 64 mg/dL. ounces orange juice, which the client consumes, and the client begins to speak more coherently. The nurse contacts the health specific orders.
Determine whether each requested order is indicated or unnecessary. Each requested order supports 1 choice.
Requested Order
Place on NPO status
Prepare for intubation
Increase oxygen to 4 L per nasal cannula
Administer bolus of 0.9% normal saline
Change nasal cannula to facemask
Administer metformin twice daily
Increase fingerstick blood glucose order to PRN
Indicated Unnecessary
A client who received a lung transplant 9 months ago contacts the telehealth nurse to report an ongoing dry cough that began 3 d response is appropriate?
Answers: A – D
A “Please go to your nearest emergency department to be evaluated.”
“It is normal to occasionally have a dry cough after lung transplantation.”
C “Using an over-the-counter cough suppressant can alleviate your symptoms.”
D
“As long as the cough does not last more than a week, you don’t need to worry.”
Answers: A – D
A “Please go to your nearest emergency department to be evaluated.”
“It is normal to occasionally have a dry cough after lung transplantation.”
C “Using an over-the-counter cough suppressant can alleviate your symptoms.”
D “As long as the cough does not last more than a week, you don’t need to worry.”
Answers: A-D
A He will need to wear a continuous glucose monitor during the procedure
B Metformin will need to be held 48 hours before and after the CT scan
C Glipizide will need to be held 48 hours before and after the CT scan
D He will need to have a Foley catheter placed prior to the CT scan to monitor urine output
Question 61
FLAG QUESTION
A patient with type 2 diabetes mellitus takes Glucophage (metformin) 1000 mg BID and Glucotrol (glipizide) 2.5 mg daily. This sam scheduled for a head CT (computed tomography) with contrast. What is an important consideration in preparing this patient for a h
Answers: A – D
A He will need to wear a continuous glucose monitor during the procedure
B Metformin will need to be held 48 hours before and after the CT scan
C Glipizide will need to be held 48 hours before and after the CT scan
D He will need to have a Foley catheter placed prior to the CT scan to monitor urine output
Currently Selected: B
A Assess creatinine clearance using a 24-hour urine collection test.
B Assess for coexisting conditions of diabetes, heart failure, and kidney disease.
C Collaborate with the provider about whether IV fluids should be infused before the test.
D Notify the provider regarding changes in serum creatinine from 0.2 to 0.4 mg/dL in 24 hours. (Reference range: 0.5-1.1 mg/
E Alert the provider to a glomerular filtration rate (GFR) below 60 mL/min/1.73 m2. (Reference range: >60 mL/min/1.73 m2)
Answers: A – E
A Assess creatinine clearance using a 24-hour urine collection test.
B Assess for coexisting conditions of diabetes, heart failure, and kidney disease.
C Collaborate with the provider about whether IV fluids should be infused before the test.
E Alert the provider to a glomerular filtration rate (GFR) below 60 mL/min/1.73 m2. (Reference range: >60 mL/min/1.73 m2)
Answers: A-G
A Assess orientation.
B Apply cardiac monitor.
C Discourage fluid intake.
D Plan to take daily weights.
E Record intake and output.
F Prepare to administer cortisol replacement therapy.
G Ensure informed consent for hypophysectomy is signed.
Glucose (Reference range 74-106 mg/dL [4.1-5.9 mmol/L])
67 mg/dL (3.7 mmol/L)
73 mg/dL (4.05 mmol/L)
Answers: A-G
A Assess orientation.
B Apply cardiac monitor.
C Discourage fluid intake.
D Plan to take daily weights.
E Record intake and output.
Question 57 v FLAG QUESTION
Parameters
Results Today (0702)
Results 12 Hours Ago (0736)
Res
(07
Serum sodium (Reference range 136-145 mEq/L [136-145 mmol/L])
129 mEq/L (129
138 mEq/L (138 mmol/L)
mmol/L)
Question 57
FLAG QUESTION
Serum sodium (Reference range 136-145 mEq/L [136-145 mmol/L])
129 mEq/L (129 mmol/L)
138 mEq/L (138 mmol/L)
140
Serum potassium (Reference range 3.5-5 mEq/L [3.5-5 mmol/L])
6.5 mEq/L (6.5 mmol/L)
5.8 mEq/L (5.8 mmol/L)
Glucose (Reference range 74-106 mg/dL [4.1-5.9 mmol/L])
67 mg/dL (3.7 mmol/L)
73 mg/dL (4.05 mmol/L)
81 m
Question 57 V
FLAG QUESTION
Parameters
Results Today (0702)
Results 12 Hours Ago (0736)
Re
Serum sodium (Reference range 136-145 mEq/L [136-145 mmol/L])
129 mEq/L (129
138 mEq/L (138 mmol/L)
14
mmol/L)
Answers: A-G
A Assess orientation.
B Apply cardiac monitor.
C Discourage fluid intake
The nurse is caring for a client with hypovolemic shock. Which order would the nurse question?
Answers: A – D
A Type and crossmatch for blood administration.
B Decrease the rate of normal saline.
C Prepare for surgical hemostasis of large wound.
D Obtain consent for central line placement.
Question 54 V FLAG QUESTION
Which of the following is true regarding percutaneous coronary intervention (PCI)?
Answers: A-D
A The catheter is inserted into the inferior jugular vein and threaded into the heart
B The balloon remains in the coronary artery after the catheter is withdrawn in order to keep the artery open
C Patients with angina will likely experience reduction in chest pain following PCI
D PCI is performed using clean technique
Question 52
FLAG QUESTION
Answers: A-E
A Obtain vital signs.
B Check body temperature.
C Review medication record.
D Measure intake and output.
E Assess swallowing reflex.
Answers: A-D
A Heparin
B Nimodipine
C Alteplase
D Aspirin
Answers: A – D
A Bradycardia
B Oliguria
C Bruising
D Enlarged prostate
The nurse is caring for a client with multiple rib fractures. The client reports chest pain and shortness of breath, and assessment breath sounds of the left side, HR 115 beats/min, BP 85/50 mm Hg, Sp02 86% on room air. Which nursing action is the priority?
Answers: A – D
A Initiate oxygen therapy.
B Notify the respiratory therapist.
C Alert the trauma team or Rapid Response Team.
D Apply noninvasive mechanical ventilation.
Question 48
FLAG QUESTION
Which of the following findings does the nurse anticipate observing in the patient with acute rejection of a heart transplant?
Answers: A-D
A hematuria
B uremic frost
C petechiae
D ejection fraction 25%
Action To Take
Administer oxygen at 2 L/min via nasal cannula
Sit the client upright and offer distraction
Draw blood cultures
Potential Condition
Parameter to Monitor
Septic shock
Hypovolemic shock
Pulse rate and quality
Anxiety
Urine output
Prioritize the ordered abdominal
scans
Cardiogenic shock
Serum glucose level
Assess blood alcohol level
White blood cell count
Currently taking albuterol as needed for asthma, duloxetine, and NSAIDs regularly for pain associated with endometriosis. The client reports that she is thirsty.
1600: Seen by provider immediately on arrival. Labs, abdominal scan, and head CT ordered along with fluids. 1605: Normal saline started at 80 mL/hr. Labs drawn and sent to lab. Patient reports thirst and that she is
cold and wants to be left alone.
1610: Vital signs: BP 120/80 mm Hg; RR 28 breaths/min; O, saturation 94% on RA; HR 121 beats/min. 1625: The client reports that “something bad is happening” and identifies diffuse abdominal pain. Vital signs:
BP 110/88 mm Hg; RR 32 breaths/min; O, saturation 90% on RA; HR 130 beats/min. The client’s skin is moist and clammy.
Complete the diagram by selecting from the choices below to specify what potential condition the client is likely experiencing, appropriate to take, and 2 parameters the nurse should monitor to assess the client’s progress.
Action To Take
Action To Take
Parameter to M
Hypovolemic shock
Parameter to M
Which of the following patients should be transferred to a burn center?
Answers: A-D
A The 45-year-old male patient with redness and pain of the right thigh after spilling a hot cup of coffee on himself
B The 80-year-old female with a burn to her face as a result of a scald injury
C
D The 50-year-old patient with 2nd degree (partial thickness) burns to the ventral surface of the right arm
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