NURS 3632-600 Exam 2

Question 2

NURS 3632-600 Exam 2. The nurse is teaching a patient who had a cholecystectomy one day ago about coughing and deep breathing. The patient states, “I don’t want to cough because it hurts.” What is the nurse’s best response?

• It is okay to wait until your pain is better before trying to do the cough and deep breathing exercises.
• “You can hold a pillow over your stomach to reduce pain while coughing and deep breathing.”
• “I am concerned about your lungs. If you do not do these exercises you could develop an infection at your surgical site.”
• “If it hurts to cough, I would avoid doing that. We can focus on deep breathing instead.”

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Question 3

The nurse enters the patient’s room and observes them lying flat with cyanosis of the lips and tongue. What intervention should be implemented first?

• Apply humidification to the oxygen nasal cannula.
• Active the emergency response system.
• Assess pulse oxygen saturation.
• Sit the head of bed up as high as possible.

Question 5

When planning nursing interventions for patients with sensory alterations, the nurse must first consider the patient’s…? NURS 3632-600 Exam 2

• Emotional state.
• Activity level.
• Social support.
• Safety.

Question 6

Which of the following are considered modifiable risk factors for heart disease? (Select all that apply)

• Diet.
• Age.
• Exercise.
• Smoking.
• Genetics.

Question 7

Which assessment finding by the nurse indicates that an older adult patient is adapting to presbycusis?

• The patient withdraws from social activities in the dayroom.
• The patient requests the nurse to speak in a high-pitched voice.
• The patient avoids using hearing aids in public settings.
• The patient turns one ear toward the nurse during conversation.

Question 37

NURS 3632-600 Exam 2. The provider has advanced a patient’s diet from NPO (nothing to eat or drink) to pureed foods with nectar thick liquids following an aspiration episode. Which nursing intervention is the priority to reduce the risk of aspiration?

• Assess for signs of aspiration while eating.
• Elevate the head of bed as close to 90° as possible.
• Provide oral care before meals.
• Keep the patient NPO until they pass a swallow evaluation.

Question 38

You are providing care for a patient on a clear liquid diet. You know your teaching about the clear liquid diet has been effective when the patient chooses which of the following meals?

• Chicken broth with Jell-O and coffee.
• Vegetable broth with yogurt and apple juice.
• Chicken noodle soup with Pedialyte and tea.
• Tomato soup with a popsicle and water. NURS 3632-600 Exam 2

Question 39

A nurse is monitoring a patient on total parenteral nutrition (TPN). What is the most important assessment associated with this type of nutrition? NURS 3632-600 Exam 2

• Central venous catheter insertion site.
• Bowel sounds.
• Peripheral intravenous catheter insertion site.
• Oral intake amount.

Question 40

The nurse received report for the following patients. Which patient should be seen first due to high risk of aspiration?

• 89-year-old with dementia and nasogastric tube with continuous tube feeding.
• 65-year-old who is “nothing by mouth” for a planned surgery.
• 73-year-old with hypoactive bowel sounds one day post cholecystectomy.
• 43-year-old with anorexia and nausea for two days who is tolerating a clear liquid diet.

Question 41

The nurse has just admitted a 92-year-old patient with bilateral lower extremity strength of 3/5 to the hospital. What intervention would be important to implement at this time? NURS 3632-600 Exam 2

• Provide a high protein snack to improve muscle strength.
• Ensure personal items and call light are within reach.
• Raise all side rails to prevent the patient from getting out of bed.
• Encourage leg exercises while in bed or up in the chair.

Question 42

A nurse enters a patient’s room and finds that the patient has fallen on the way to the bathroom. What action should be taken first?

• Get the patient back to bed safely.
• Call for additional assistance.
• Notify the charge nurse immediately.
• Assess the patient for injuries.

Question 43

86-year-old patient with weakness, poor vision and diabetes mellitus type two is being discharged after accidentally overdosing on their antihypertensives. What instruction would be important to provide during discharge teaching? NURS 3632-600 Exam 2

• “Be sure to report any side effects related to your medications to your provider.”
• “You can fill your prescriptions from different pharmacy so the pills look different.”
• “You should avoid taking your medications with alcohol or opiates.”
• “You should request large print labels from the pharmacist when filling your prescriptions.”

Question 44

A student goes into a patient room after hearing the bed alarm sounding and IV beeping. The patient states, “These alarms are so annoying. Can you shut them off?” What is the best response by the student? NURS 3632-600 Exam 2

• “The alarms can be annoying. I will turn off your bed alarm since you are alert. Just don’t fall.”
• “I can understand that the alarms can be loud; they are on for your safety. I will be sure that I am rounding on you hourly to check on you.”
• “It sounds like these alarms are preventing you from getting rest. I can turn the volume down so they aren’t so loud.”
• “The alarms are required per hospital policy. Just use your call bell if they are going off.”

Question 45

The provider orders 2.5 grams of vancomycin to be given in four equal doses. How many milligrams will be given per dose? Enter whole number only. Do not include a unit of measure. NURS 3632-600 Exam 2

• 625

Question 46

The provider writes an order for acetaminophen 245 mg by mouth every 6 hours for pain for an eleven-year-old boy who weighs 90 pounds. The pharmacy sends the medication: Children’s Tylenol (160 mg per 5 mL). How many mL do you need to administer to the patient? Round to the tenth place. Do not include a unit of measure. NURS 3632-600 Exam 2

• 7.7

Question 47

The nurse is preparing medications to administer to their patient that includes amlodipine for hypertension, levothyroxine for hypothyroidism, and aspirin for myocardial infarction prevention. The patient states that they do not want to take the amlodipine because it makes them feel funny. The patient’s blood pressure is 198/102 so the nurse puts the pill in the medicine cup and gives it to the patient. What right did the nurse violate?

• Right to refuse
• Right reason
• Right to education
• Right documentation

Question 48

The nurse is preparing to administer diltiazem to their patient per provider orders: Diltiazem 180 mg PO once a day for hypertension. Hold for systolic blood pressure under 110 or heart rate under 60. The nurse assessed the patient’s vital signs: Blood Pressure 148/84, Heart Rate 58. What action should the nurse take next?

• Administer the medication for the hypertension.
• Call the provider and ask them to adjust the dose.
• Reassess the vital signs in 15 minutes.
• Hold the medication.

Question 49

A dose of 3750mg of medication has been ordered for a patient. The medication comes in 5g/2mL. How many mL will you administer to the client? Round to the tenth place. Do not include a unit of measure.

• 1.5

Question 50

The student nurse is preparing to administer medications with the primary nurse. What statement by the student nurse would need immediate intervention by the primary nurse prior to administration?

• “I will perform the second medication administration check at the bedside prior to preparing the medication.”
• “I will confirm the medication name, dose, route and time for the two required times.”
• “I will provide education to the patient about the medications and side effects prior to administration.” NURS 3632-600 Exam 2
• “I will verify the patient prior to administration using two identifiers such as name and date of birth.”

Question 51

The provider has ordered a medication for a patient in the electronic health record. The nurse compares the ordered medication to the drug guide: Drug Guide (Heparin, Dosage: 5000 units TID, Route: subcutaneous injection) vs Provider Order (Heparin 5000 U SQ TID). What part of this order requires clarification by the nurse prior to administering the medication?

• The route
• The medication
• The dosage
• The frequency NURS 3632-600 Exam 2