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Showing all 10 practice questions with expert explanatory rationales.

Question 1 of 10

Often children are monitored with pulse oximeter. The pulse oximeter measures the:

A. O₂ content of the blood
B. Oxygen saturation of arterial blood
C. PO₂
D. Affinity of hemoglobin for O₂

Expert Explanatory Rationale

Correct Answer: Oxygen saturation of arterial blood

Question 2 of 10

A 29-year-old client is admitted for a hysterectomy. She has repeatedly told the nurses that she is worried about having this surgery, has not slept well lately, and is afraid that her husband will not find her desirable after the surgery. Shortly into the preoperative teaching, she complains of a tightness in her chest, a feeling of suffocation, lightheadedness, and tingling in her hands. Her respirations are rapid and deep. Assessment reveals that the client is:

A. Having a heart attack
B. Wanting attention from the nurses
C. Suffering from complete upper airway obstruction
D. Hyperventilating

Expert Explanatory Rationale

Correct Answer: Hyperventilating

Question 3 of 10

The nurse is preparing to administer a feeding via a nasogastric tube. The nurse would perform which of the following before initiating the feeding?

A. Assess for tube placement by aspirating stomach content.
B. Place the patient in a left-lying position.
C. Administer feeding with 50% Dextrose.
D. Ensure that the feeding solution has been warmed in a microwave for two minutes.

Expert Explanatory Rationale

Correct Answer: Assess for tube placement by aspirating stomach content.

Question 4 of 10

The nurse is assessing a trauma client in the emergency room when she notes a penetrating abdominal wound with exposed viscera. The nurse should:

A. Apply a clean dressing to protect the wound.
B. Cover the exposed viscera with a sterile saline gauze.
C. Gently replace the abdominal contents.
D. Cover the area with a petroleum gauze.

Expert Explanatory Rationale

Correct Answer: Cover the exposed viscera with a sterile saline gauze.

Question 5 of 10

A 52-year-old client who underwent an exploratory laparotomy for a bowel obstruction begins to complain of hunger on the third postoperative day. His nasogastric (NG) tube was removed this morning, and he has an IV of D5W with 0.45% normal saline running at 125 mL/hr. He asks when he can get rid of his IV and start eating. The nurse recognizes that he will be able to begin taking oral fluids and nourishment when:

A. It is determined that he has no signs of wound infection
B. He is able to eat a full meal without evidence of nausea or vomiting
C. The nurse can detect bowel sounds in all four quadrants
D. His blood pressure returns to its preoperative baseline level or greater

Expert Explanatory Rationale

Correct Answer: The nurse can detect bowel sounds in all four quadrants

Question 6 of 10

A client with a history of phenylketonuria (PKU) is seen in the local family planning clinic. While completing the intake history, the nurse provides information for a healthy pregnancy. Which statement indicates that the client needs further teaching?

A. I can use artificial sweeteners to keep me from gaining too much weight when I get pregnant.
B. I need to go back on a low-phenylalanine diet before I get pregnant.
C. Fresh fruits and raw vegetables will make good between-meal snacks for me.
D. My baby could be mentally retarded if I don't stick to a diet eliminating phenylalanine.

Expert Explanatory Rationale

Correct Answer: I can use artificial sweeteners to keep me from gaining too much weight when I get pregnant.

Question 7 of 10

A 9-year-old child was in the garage with his father, who was repairing a lawnmower. Some gasoline ignited and caused an explosion. His father was killed, and the child has split-thickness and full-thickness burns over 40% of his upper body, face, neck, and arms. All of the following nursing diagnoses are included on his care plan. Which of these nursing diagnoses should have top priority during the first 24-48 hours postburn?

A. Pain related to tissue damage from burns
B. Potential for infection related to contamination of wounds
C. Fluid volume deficit related to increased capillary permeability
D. Potential for impaired gas exchange related to edema of respiratory tract

Expert Explanatory Rationale

Correct Answer: Potential for impaired gas exchange related to edema of respiratory tract

Question 8 of 10

A male client is scheduled for a liver biopsy. In preparing him for this test, the nurse should:

A. Explain that he will be kept NPO for 24 hours before the exam
B. Practice with him so he will be able to hold his breath for 1 minute
C. Explain that he will be receiving a laxative to prevent a distended bowel from applying pressure on the liver
D. Explain that his vital signs will be checked frequently after the test

Expert Explanatory Rationale

Correct Answer: Explain that his vital signs will be checked frequently after the test

Question 9 of 10

In the client with a diagnosis of coronary artery disease, the nurse would anticipate the complication of bradycardia with occlusion of which coronary artery?

A. Right coronary artery
B. Left main coronary artery
C. Circumflex coronary artery
D. Left anterior descending coronary artery

Expert Explanatory Rationale

Correct Answer: Right coronary artery

Question 10 of 10

Which finding is expected in the normal newborn?

A. Epstein pearls
B. Moro reflex
C. Swan neck deformity
D. Cracked pot sound

Expert Explanatory Rationale

Correct Answer: Moro reflex

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