Management of patients with various disorders of Renal system, Respiratory system, GI system, CVS system, haematological system, neurological system, and endocrine system.
Time: 15:00
A patient is admitted with an acute exacerbation of heart failure (CHF). Which nursing assessment is the most reliable indicator of their fluid volume status?
[a] Intake and output records.
[b] Presence of peripheral edema.
[c] Daily weight measurement.
[d] Lung sounds auscultation.
A nurse is caring for a patient with Chronic Obstructive Pulmonary Disease (COPD). Which technique should the nurse teach the patient to help with dyspnea by prolonging exhalation and preventing air trapping?
[a] Huff coughing.
[b] Deep breathing and coughing.
[c] Pursed-lip breathing.
[d] Abdominal breathing.
What is the priority nursing intervention for a patient with acute pancreatitis?
[a] Encouraging a low-fat diet.
[b] Administering oral medications.
[c] Keeping the patient NPO (nothing by mouth) and managing pain.
[d] Monitoring for signs of constipation.
A patient is admitted to the emergency department with Diabetic Ketoacidosis (DKA). What is the initial priority in managing this patient?
[a] Administering a bolus of regular insulin intravenously.
[b] Correcting the hyperglycemia.
[c] Initiating intravenous fluid resuscitation.
[d] Administering sodium bicarbonate for acidosis.
What is the earliest and most sensitive indicator of increased intracranial pressure (ICP)?
A patient with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L. The nurse should immediately assess the patient for:
[a] Seizures.
[b] Cardiac dysrhythmias.
[c] Respiratory depression.
[d] Dehydration.
The nurse is creating a plan of care for a patient with a platelet count of 35,000/mm³. Which intervention is most important to include?
[a] Encouraging ambulation to prevent DVT.
[b] Monitoring temperature for signs of infection.
[c] Implementing bleeding precautions (e.g., using a soft toothbrush, avoiding IM injections).
[d] Maintaining a high-protein diet.
A patient is experiencing an acute asthma attack with audible wheezing. The nurse should prepare to administer which medication first?
[a] An inhaled corticosteroid (e.g., fluticasone).
[b] A long-acting beta-agonist (e.g., salmeterol).
[c] A short-acting beta-agonist (e.g., albuterol).
[d] An oral leukotriene modifier (e.g., montelukast).
A nurse is caring for a patient with liver cirrhosis who has developed ascites and hepatic encephalopathy. A key nursing intervention is to monitor:
[a] Serum glucose levels.
[b] Urine specific gravity.
[c] Serum ammonia levels.
[d] Serum calcium levels.
A patient is admitted with an ischemic stroke. The nurse knows that to be a candidate for thrombolytic therapy (tPA), the patient must be treated within a specific time frame, which is typically:
[a] Within 24 hours of symptom onset.
[b] Within 12 hours of symptom onset.
[c] Within 6 hours of symptom onset.
[d] Within 3 to 4.5 hours of symptom onset.
A child with acute post-streptococcal glomerulonephritis is being monitored in the hospital. The nurse should prioritize assessment for which complication?
[a] Hypoglycemia.
[b] Hypertension.
[c] Hypokalemia.
[d] Dehydration.
What is the priority nursing management for a child experiencing a sickle cell vaso-occlusive crisis?
[a] Administering anticoagulants and applying cold compresses.
[b] Restricting fluids and encouraging bed rest.
[c] Providing aggressive pain management and intravenous hydration.
[d] Preparing for an immediate blood transfusion.
A patient with a new diagnosis of hypertension is being discharged. Which statement by the patient indicates a need for further teaching?
[a] "I will need to monitor my blood pressure at home."
[b] "I should reduce the amount of salt in my diet."
[c] "I can stop taking my medication once my blood pressure is normal."
[d] "I plan to start a regular exercise program."
The nurse is caring for a patient who has just returned from an EGD (esophagogastroduodenoscopy). What is the priority nursing assessment before offering the patient oral fluids?
[a] Assessing for abdominal pain.
[b] Checking for bowel sounds.
[c] Measuring vital signs.
[d] Assessing for the return of the gag reflex.
A patient with hypothyroidism (myxedema) is admitted to the hospital. Which clinical manifestation would the nurse expect to find?
[a] Tachycardia and heat intolerance.
[b] Diarrhea and weight loss.
[c] Bradycardia and constipation.
[d] Insomnia and anxiety.
A patient in the ICU develops refractory hypoxemia (low PaO2 despite receiving high concentrations of oxygen). This is the hallmark sign of which respiratory condition?
[a] Pulmonary embolism.
[b] Pneumothorax.
[c] Acute Respiratory Distress Syndrome (ARDS).
[d] Status asthmaticus.
A nurse is caring for a patient with ulcerative colitis. The nurse should expect the patient's stools to be:
[a] Hard, pellet-like, and infrequent.
[b] Large, greasy, and foul-smelling (steatorrhea).
[c] Watery and bloody.
[d] Formed and brown.
What is the primary reason for initiating droplet precautions for a patient with suspected bacterial meningitis?
[a] To prevent the spread of the organism through contact with the patient's skin.
[b] To protect the patient from acquiring infections from staff and visitors.
[c] To prevent transmission of the organism through coughing, sneezing, or talking.
[d] To prevent the spread of the organism through airborne routes over long distances.
A nurse is teaching a patient with iron-deficiency anemia about taking ferrous sulfate. The nurse should instruct the patient to take the supplement with which of the following to enhance absorption?
[a] A glass of milk.
[b] An antacid.
[c] A glass of orange juice.
[d] A meal high in fiber.
What is the most significant risk associated with atrial fibrillation?
[a] Ventricular tachycardia.
[b] Complete heart block.
[c] Hypertensive crisis.
[d] Thromboembolic events, such as a stroke.
A patient is taking the diuretic furosemide (Lasix). The nurse should closely monitor which electrolyte for a potential imbalance?
[a] Sodium.
[c] Potassium.
[b] Calcium.
[d] Magnesium.
The nurse is preparing to administer a scheduled dose of insulin to a patient with Type 1 diabetes. The patient is alert but reports feeling shaky and sweaty. What is the nurse's first action?
[a] Administer the insulin as ordered.
[b] Offer the patient a protein-rich snack.
[c] Check the patient's capillary blood glucose level.
[d] Notify the physician immediately.
A child is diagnosed with nephrotic syndrome. The nurse expects the urinalysis to show which classic finding?
[a] Large amounts of red blood cells (hematuria).
[b] Massive amounts of protein (proteinuria).
[c] High levels of glucose (glucosuria).
[d] Presence of bacteria and white blood cells.
A patient in the ER has a suspected myocardial infarction (MI). After establishing IV access and placing the patient on a cardiac monitor, the nurse's priority is to:
[a] Administer a dose of beta-blocker.
[b] Obtain a 12-lead ECG.
[c] Administer oxygen.
[d] Administer sublingual nitroglycerin.
The nurse finds a patient having a tonic-clonic seizure. The priority nursing action during the seizure is to:
[a] Insert a padded tongue blade into the patient's mouth.
[b] Restrain the patient's limbs to prevent injury.
[c] Administer an IV anticonvulsant medication.
[d] Protect the patient from injury and maintain a patent airway.
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