Adult Health Clinical Nurse Specialist Exam Prep Test

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| By Catherine Halcomb
Catherine Halcomb
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Adult Health Clinical Nurse Specialist Exam Prep Test - Quiz

Welcome to the Adult Health Clinical Nurse Specialist Exam Prep Test. This questionnaire has more than twenty-five questions about some of the fundamental duties and technical work a nurse must carry out. So, if you are aspiring to become an adult health clinical nurse, this quiz might help you clear your exam.


Questions and Answers
  • 1. 

    The nurse is monitoring the client’s laboratory values. Which laboratory report is diagnostic for a urinary tract infection (UTI)?

    • A.

      Hemogram

    • B.

      Urinalysis

    • C.

      Urine Culture

    • D.

      Metanephrines

    Correct Answer
    C. Urine Culture
    Explanation
    A urine culture is the most diagnostic laboratory report for a urinary tract infection (UTI). This test involves growing bacteria from a urine sample in a laboratory setting to identify the specific bacteria causing the infection. This helps determine the most effective antibiotic treatment for the UTI. Hemogram is a complete blood count test that measures different components of blood and is not specific to UTIs. Urinalysis is a test that examines the physical, chemical, and microscopic properties of urine, but it may not always confirm the presence of a UTI. Metanephrines are substances that are tested to diagnose certain adrenal gland tumors and are not related to UTIs.

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  • 2. 

    The nurse is caring for a client diagnosed with chronic renal failure (CRF). Which antecedents would the nurse assess? Select all that apply.

    • A.

      Current diet.

    • B.

      Diabetes.

    • C.

      Hypertension.

    • D.

      Fluid restitions.

    • E.

      Race

    Correct Answer(s)
    B. Diabetes.
    C. Hypertension.
    E. Race
    Explanation
    The nurse would assess for diabetes, hypertension, and race as antecedents in a client diagnosed with chronic renal failure (CRF). Diabetes and hypertension are common risk factors for developing CRF, as they can lead to damage in the kidneys over time. Race is also a known risk factor, as certain ethnicities, such as African Americans, have a higher prevalence of CRF. Assessing the client's current diet and fluid restrictions may be important in managing their condition, but they are not considered antecedents in this context.

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  • 3. 

    The client is in the intensive care department (ICD) after a motor-vehicle accident in which the client lost an estimated three (3) units of blood. Which action by the nurse could prevent the client from developing acute renal failure?

    • A.

      Take and document the client’s vital signs every hour.

    • B.

      Assess the client’s dressings every two (2) hours.

    • C.

      Check the client’s urinary output every shift.

    • D.

      Maintain the client’s blood pressure greater than 100/60.

    Correct Answer
    D. Maintain the client’s blood pressure greater than 100/60.
    Explanation
    Maintaining the client's blood pressure greater than 100/60 is important in preventing the client from developing acute renal failure. Adequate blood pressure ensures sufficient perfusion to the kidneys, which is essential for their proper function. Acute renal failure can occur when there is inadequate blood flow to the kidneys, leading to ischemia and damage. By maintaining the client's blood pressure within the appropriate range, the nurse can help ensure adequate renal perfusion and reduce the risk of acute renal failure.

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  • 4. 

    The nurse has identified the concept of urinary elimination for a client. Which information is most important for the nurse to provide to the health-care provider the next day? Day One (Shift Time) Oral (in mL) Intravenous (in mL) Urine (in mL) Nasogastric Tube (in mL) Other (Specific) (in mL) 0701-1500 2100 1000 435   Emesis 40 1501-2300 1500 1000 375     2301-0700 200 1000 500     Total 3800 3000 1310   40

    • A.

      The client vomited 40 mL on the day shift.

    • B.

      The client has an adequate oral intake, and IV fluids are not needed.

    • C.

      The client has had 6,800 mL intake and 1,350 mL output in the last 24 hours.

    • D.

      The client does not like to have to keep the urine for measurement.

    Correct Answer
    C. The client has had 6,800 mL intake and 1,350 mL output in the last 24 hours.
    Explanation
    The nurse should provide the information about the client's intake and output in the last 24 hours to the healthcare provider. This information is important as it gives an overall picture of the client's urinary elimination and fluid balance. It helps the healthcare provider assess the client's hydration status and determine if any interventions are needed.

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  • 5. 

    The client diagnosed with chronic renal failure (CRF) is prescribed hemodialysis on Monday, Wednesday, and Friday. Which interventions should the dialysis nurse implement? Select all that apply.

    • A.

      Weigh the client before and after each treatment.

    • B.

      Discuss the recommended fluid restriction.

    • C.

      Provide potato chips or pretzels as a snack.

    • D.

      Monitor the hemodialysis access site continuously.

    • E.

      Keep up a lively conversation during the treatments.

    Correct Answer(s)
    A. Weigh the client before and after each treatment.
    B. Discuss the recommended fluid restriction.
    D. Monitor the hemodialysis access site continuously.
    Explanation
    The client diagnosed with chronic renal failure (CRF) requires hemodialysis to remove waste products and excess fluid from the body. Weighing the client before and after each treatment helps to assess the effectiveness of dialysis in removing fluid. Discussing the recommended fluid restriction is important to prevent fluid overload between treatments. Monitoring the hemodialysis access site continuously ensures its proper functioning and detects any complications. Providing potato chips or pretzels as a snack is not appropriate as they are high in sodium, which can worsen fluid retention. Keeping up a lively conversation during treatments is not a necessary intervention for the dialysis nurse to implement.

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  • 6. 

    The nurse is administering morning medications. Which medication should the nurse question administering? Client Name: ACC Admitting Diagnosis: Acute Renal Failure Account Number: 678905 Med Rec #: 01 01 02 Allergies Penicillin Date | Medication | 2301–0700 | 0701–1500 | 1501–2300 Yesterday | Furosemide (Lasix) 80 mg PO daily | - | 0900 K1 4.3 | - | Yesterday | Erythropoietin (Epogen) Sub Q daily times 3 days | - | 0900 | - | Yesterday | Multivitamin with iron PO daily | - | 0900 | - | Yesterday | Levothyroxine (Synthroid) 0.75 mcg PO daily | - | 0900 | - | Signature of Nurse: Day Nurse RN (DN)

    • A.

      Furosemide.

    • B.

      Erythropoietin.

    • C.

      Multivitamin with iron.

    • D.

      Levothyroxine.

    Correct Answer
    B. Erythropoietin.
    Explanation
    The nurse should question administering Erythropoietin because it was ordered to be given for three days, but it was only administered once yesterday. This medication should have been given again today, but there is no record of it being administered during the morning medication round.

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  • 7. 

    The nurse identifies the concepts of elimination and immunity for a female client diagnosed with a urinary tract infection. Which discharge instructions should the nurse provide the client? Select all that apply.

    • A.

      Teach the client to wipe from front to back after voiding.

    • B.

      Encourage the client to drink cranberry juice each morning.

    • C.

      Inform the client that frequent episodes of incontinence are expected.

    • D.

      Discuss the signs and symptoms of a recurrent infection.

    • E.

      Have the client fill a container of water to sip until at least 2,000 mL is consumed.

    • F.

      Request that the client sit in a tub of warm water twice a day for 25 minutes.

    Correct Answer(s)
    A. Teach the client to wipe from front to back after voiding.
    B. Encourage the client to drink cranberry juice each morning.
    D. Discuss the signs and symptoms of a recurrent infection.
    E. Have the client fill a container of water to sip until at least 2,000 mL is consumed.
    Explanation
    The nurse should teach the client to wipe from front to back after voiding to prevent the spread of bacteria from the anal area to the urinary tract. Encouraging the client to drink cranberry juice each morning is also appropriate as it can help prevent urinary tract infections. Discussing the signs and symptoms of a recurrent infection is important for the client to be able to recognize and seek treatment promptly. Having the client fill a container of water to sip until at least 2,000 mL is consumed promotes frequent urination, which can help flush out bacteria from the urinary tract.

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  • 8. 

    The client diagnosed with chronic renal failure (CRF) is prescribed a 60-gm protein, 2,000-mg sodium diet. Which food choices indicate the client understands the dietary restrictions?

    • A.

      A 4-ounce grilled chicken breast, broccoli, and small glass of unsweet tea.

    • B.

      Baked potato with chopped ham and sour cream, 12-ounce steak, and beer.

    • C.

      Double patty cheeseburger, french fries, and saccharin sweet Kool Aid.

    • D.

      Roast beef sandwich, potato chips, and soft drink.

    Correct Answer
    A. A 4-ounce grilled chicken breast, broccoli, and small glass of unsweet tea.
    Explanation
    The client with chronic renal failure (CRF) needs to follow a low-protein and low-sodium diet to manage their condition. Option A, which includes a grilled chicken breast (a lean source of protein), broccoli (a low-sodium vegetable), and unsweetened tea (low in sodium), indicates that the client understands and is following their dietary restrictions. Option B includes high-sodium foods like ham, sour cream, and steak, as well as beer, which is also high in sodium. Option C includes a cheeseburger and french fries, which are both high in sodium, and saccharin sweet Kool Aid, which is not recommended for clients with CRF. Option D includes roast beef (high in protein and sodium), potato chips (high in sodium), and a soft drink (high in sodium).

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  • 9. 

    The elderly client presents to the emergency department complaining of burning on urination with an urgency to void, and a temperature of 99.8°F. Which intervention should the nurse implement first?

    • A.

      Ask the client to provide a clean voided midstream urine for culture.

    • B.

      Insert an 18-gauge peripheral IV catheter and start normal saline fluids.

    • C.

      Arrange for the client to be admitted to the medical unit.

    • D.

      Initiate the ordered intravenous antibiotic medication.

    Correct Answer
    A. Ask the client to provide a clean voided midstream urine for culture.
    Explanation
    The client's symptoms of burning on urination, urgency to void, and a low-grade fever suggest a urinary tract infection (UTI). The first intervention should be to obtain a clean voided midstream urine sample for culture to confirm the presence of a UTI and identify the causative organism. This will guide appropriate antibiotic therapy. Initiating antibiotic treatment without confirming the diagnosis through urine culture may lead to unnecessary antibiotic use and potential antibiotic resistance. Inserting an IV catheter and starting fluids, arranging for admission, and initiating IV antibiotics can be done after the urine culture results are obtained.

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  • 10. 

    The client diagnosed with a urinary tract infection has a blood pressure of 83/56 mm Hg and a pulse of 122 bpm. Which should the nurse implement first?

    • A.

      Notify the health-care provider (HCP).

    • B.

      Hang the IVPB antibiotic at the prescribed rate.

    • C.

      Check the laboratory work to determine if the urine culture has been completed.

    • D.

      Increase the normal saline IV fluids from keep open to 150 mL/hour on the IV pump.

    Correct Answer
    D. Increase the normal saline IV fluids from keep open to 150 mL/hour on the IV pump.
    Explanation
    The client's low blood pressure and elevated heart rate indicate hypovolemia, which could be caused by the urinary tract infection. Increasing the normal saline IV fluids will help to restore fluid volume and improve blood pressure. This intervention should be implemented first to stabilize the client's condition. Notifying the health-care provider, hanging the antibiotic, or checking the urine culture can be done after addressing the immediate concern of hypovolemia.

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  • 11. 

    The nurse enters the client’s room and notes an unconscious client with an absence of respirations and no pulse or blood pressure. The concept of perfusion is identified by the nurse. Which should the nurse implement first?

    • A.

      Notify the health care provider.

    • B.

      Call a rapid response team (RRT).

    • C.

      Determine the telemetry monitor reading.

    • D.

      Push the Code Blue button.

    Correct Answer
    D. Push the Code Blue button.
    Explanation
    In this scenario, the nurse recognizes that the client is experiencing a cardiac arrest, as evidenced by the absence of respirations, pulse, and blood pressure. Pushing the Code Blue button is the correct action to take first as it activates the emergency response team and initiates the necessary interventions for resuscitation. This action ensures that immediate help is on the way to provide life-saving measures, such as CPR and defibrillation, to restore perfusion and circulation.

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  • 12. 

    The 45-year-old male client diagnosed with essential hypertension has decided not to take his medications. The client’s BP is 178/94, indicating a perfusion issue. Which question should the nurse ask the client first?

    • A.

      “Do you have the money to buy your medication?”

    • B.

      “Does the medication give unwanted side effects?”

    • C.

      “Did you quit taking the medications because you don’t feel bad?”

    • D.

      “Can you tell me why you stopped taking the medication?”

    Correct Answer
    B. “Does the medication give unwanted side effects?”
    Explanation
    The nurse should ask the client if the medication gives unwanted side effects first because this question directly addresses the client's decision to stop taking the medication. By understanding if the medication is causing unwanted side effects, the nurse can explore alternative treatment options or work with the client to manage the side effects effectively, thus improving medication adherence and addressing the client's perfusion issue.

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  • 13. 

    The nurse identifies the concept of altered tissue perfusion related to a client admitted with atrial fibrillation. Which interventions should the nurse implement? Select all that apply.

    • A.

      Monitor the client’s blood pressure and apical rate every four (4) hours.

    • B.

      Place the client on intake and output every shift.

    • C.

      Require the client to sleep with the head of the bed elevated.

    • D.

      Teach the patient to perform Buerger Allen exercises daily.

    • E.

      Determine if the client is on an antiplatelet or anticoagulant medication.

    • F.

      Assess the client’s neurological status every shift and prn.

    Correct Answer(s)
    A. Monitor the client’s blood pressure and apical rate every four (4) hours.
    B. Place the client on intake and output every shift.
    E. Determine if the client is on an antiplatelet or anticoagulant medication.
    F. Assess the client’s neurological status every shift and prn.
    Explanation
    The nurse should implement the interventions of monitoring the client's blood pressure and apical rate every four hours to assess for any changes in tissue perfusion. Placing the client on intake and output every shift will help the nurse monitor fluid balance and detect any signs of fluid overload or dehydration, which can impact tissue perfusion. Determining if the client is on an antiplatelet or anticoagulant medication is important as these medications can affect blood clotting and therefore tissue perfusion. Assessing the client's neurological status every shift and as needed is important to monitor for any changes in brain perfusion and potential complications.

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  • 14. 

    The nurse identifies the concept of perfusion for a client diagnosed with congestive heart failure. Which assessment data support this concept?

    • A.

      The client has a large abdomen and a positive tympanic wave.

    • B.

      The client has paroxysmal nocturnal dyspnea.

    • C.

      The client has 2+ glucose in the urine.

    • D.

      The client has a comorbid condition of myocardial infarction.

    Correct Answer
    B. The client has paroxysmal nocturnal dyspnea.
    Explanation
    Paroxysmal nocturnal dyspnea is a symptom commonly associated with congestive heart failure. It is characterized by sudden episodes of difficulty breathing during sleep, causing the client to wake up gasping for air. This symptom occurs due to fluid accumulation in the lungs, which impairs oxygenation and can be indicative of poor perfusion. Therefore, the presence of paroxysmal nocturnal dyspnea supports the concept of perfusion in a client diagnosed with congestive heart failure.

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  • 15. 

    The nurse is caring for a client diagnosed with coronary artery disease (CAD). Which should the nurse teach the client prior to discharge?

    • A.

      Carry your nitroglycerin tablets in a brown bottle.

    • B.

      Swallow a nitroglycerin tablet at the first signof angina.

    • C.

      If one nitroglycerin tablet does not work in 10 minutes, take another.

    • D.

      Nitroglycerin tablets have a fruity odor if they are potent.

    Correct Answer
    A. Carry your nitroglycerin tablets in a brown bottle.
    Explanation
    The nurse should teach the client to carry their nitroglycerin tablets in a brown bottle. Nitroglycerin is light-sensitive and can lose its potency if exposed to light. Using a brown bottle helps to protect the tablets from light and maintain their effectiveness.

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  • 16. 

    The nurse is caring for a client who suddenly complains of crushing substernal chest pain while ambulating in the hall. Which nursing action should the nurse implement first?

    • A.

      Call a Code Blue.

    • B.

      Assess the telemetry reading.

    • C.

      Take the client’s apical pulse.

    • D.

      Have the client sit down.

    Correct Answer
    D. Have the client sit down.
    Explanation
    The correct answer is to have the client sit down. This is the most appropriate nursing action to implement first because it prioritizes the client's safety and comfort. By having the client sit down, it helps to reduce the risk of falls or further injury. It also allows the nurse to assess the client's condition and provide immediate assistance if needed. Calling a Code Blue may be necessary if the client's condition worsens, but it is not the first action to take in this situation. Assessing the telemetry reading and taking the client's apical pulse can be done after ensuring the client's immediate safety.

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  • 17. 

    The client’s telemetry reading is below. Which should the nurse implement?

    • A.

      Take the client’s apical pulse and blood pressure.

    • B.

      Prepare to administer amiodarone IVPB.

    • C.

      Continue to monitor.

    • D.

      Place oxygen on the client via a nasal cannula.

    Correct Answer
    C. Continue to monitor.
    Explanation
    Based on the given information that the client's telemetry reading is below, the nurse should continue to monitor the client. This suggests that the client's condition may not be critical or in need of immediate intervention. Continuing to monitor allows the nurse to observe any changes or improvements in the client's telemetry reading over time and make further decisions or interventions accordingly.

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  • 18. 

    The nurse is functioning in the role of medication nurse during a code. Which should the nurse implement when administering amiodarone for ventricular tachycardia?

    • A.

      Mix the medication in 100 mL of fluid and administer rapidly.

    • B.

      Push the amiodarone directly into the nearest IV port and raise the arm.

    • C.

      Question the physician’s order because it is not ACLS recommended.

    • D.

      Administer via an IV pump based on mg/kg/min.

    Correct Answer
    A. Mix the medication in 100 mL of fluid and administer rapidly.
  • 19. 

    The client diagnosed with an ST elevation myocardial infarction (STEMI) has developed 2+ edema bilaterally of the lower extremities and has crackles in all lung fields. Which should the nurse implement first?

    • A.

      Notify the health care provider (HCP).

    • B.

      Assess what the client ate at the last meal.

    • C.

      Request a STAT 12 lead electrocardiogram.

    • D.

      Administer furosemide IVP.

    Correct Answer
    A. Notify the health care provider (HCP).
    Explanation
    The client's symptoms of 2+ edema bilaterally of the lower extremities and crackles in all lung fields indicate fluid overload, which can be a serious complication of STEMI. Therefore, the nurse should prioritize notifying the healthcare provider (HCP) to ensure prompt intervention and management of the client's condition. This will allow the HCP to assess the client's condition, order appropriate interventions such as diuretics, and prevent further deterioration. Assessing the client's last meal, requesting a STAT 12 lead electrocardiogram, and administering furosemide IVP may be necessary interventions, but they should be implemented after notifying the HCP.

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  • 20. 

    The nurse is administering morning medications to clients on a telemetry unit. Which medication would the nurse question?

    • A.

      Furosemide IVP to a client with a potassiumlevel of 3.6 mEq/L.

    • B.

      Digoxin orally to a client diagnosed withrapid atrial fibrillation.

    • C.

      Enalapril orally to a client whose BP is 86/64and apical pulse is 65.

    • D.

      Morphine IVP to a client complaining ofchest pain and who is diaphoretic.

    Correct Answer
    C. Enalapril orally to a client whose BP is 86/64and apical pulse is 65.
    Explanation
    The nurse would question administering enalapril orally to a client with a blood pressure of 86/64 and an apical pulse of 65. Enalapril is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension, but it can cause hypotension. Given the client's low blood pressure and heart rate, administering enalapril could further decrease blood pressure and potentially cause harm. The nurse should consult with the healthcare provider before administering the medication.

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  • 21. 

    The nurse is admitting a client diagnosed with coronary artery disease (CAD) and angina. Which concept is priority?

    • A.

      Sleep, rest, activity.

    • B.

      Comfort.

    • C.

      Oxygenation.

    • D.

      Perfusion.

    Correct Answer
    D. Perfusion.
    Explanation
    The priority concept in this scenario is perfusion. Coronary artery disease (CAD) and angina are both conditions that affect the blood flow to the heart. Perfusion refers to the adequate supply of oxygenated blood to the tissues and organs. In this case, ensuring proper perfusion is crucial to prevent further complications and provide optimal care for the client. Sleep, rest, activity, comfort, and oxygenation are all important aspects of nursing care, but in this specific situation, perfusion takes priority.

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  • 22. 

    The home health nurse is assigned a client diagnosed with heart failure. Which should the nurse implement? Select all that apply.

    • A.

      Request a dietary consult for a sodium-restricted diet.

    • B.

      Instruct the client to elevate the feet duringthe day.

    • C.

      Teach the client to weigh every morningwearing the same type of clothing.

    • D.

      Assess for edema in dependent areas of thebody.

    • E.

      Encourage the client to drink at least3,000 mL of fluid per day.

    • F.

      Have the client repeat back instructions to thenurse.

    Correct Answer(s)
    A. Request a dietary consult for a sodium-restricted diet.
    B. Instruct the client to elevate the feet duringthe day.
    C. Teach the client to weigh every morningwearing the same type of clothing.
    D. Assess for edema in dependent areas of thebody.
    F. Have the client repeat back instructions to thenurse.
    Explanation
    For a client diagnosed with heart failure, the nurse should implement several interventions. Requesting a dietary consult for a sodium-restricted diet is important to manage fluid retention and reduce strain on the heart. Instructing the client to elevate their feet during the day helps to reduce edema and improve circulation. Teaching the client to weigh themselves every morning wearing the same type of clothing allows for monitoring of fluid retention. Assessing for edema in dependent areas helps to identify any worsening of the condition. Having the client repeat back instructions to the nurse ensures understanding and compliance with the care plan.

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  • 23. 

    The telemetry monitor tech notifies the nurse of the strip shown below. Which should the nurse implement first?

    • A.

      Instruct the unlicensed assistive personnel (UAP) to check the client.

    • B.

      Go to the client’s room and assess the client personally.

    • C.

      Have the monitor tech check the client using a different lead.

    • D.

      Call for the Code Blue team and perform cardiopulmonary resuscitation.

    Correct Answer
    B. Go to the client’s room and assess the client personally.
    Explanation
    The nurse should implement going to the client's room and assessing the client personally first because it is important to directly evaluate the client's condition and gather more information before taking any further actions. By physically assessing the client, the nurse can obtain vital signs, assess the client's level of consciousness, and gather additional information that may help determine the appropriate next steps in the client's care. This allows for a more accurate and immediate response to the client's needs.

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  • 24. 

    The nurse is working with a group of new graduates on a medical-surgical unit. Which should the nurse explain about completing first morning rounds on clients?

    • A.

      Perform a “down and dirty” assessment on each client soon after receiving report.

    • B.

      Determine which client should have a bath and inform the unlicensed assistive personnel.

    • C.

      Give all the clients a wet wash to wash the face and a toothbrush and toothpaste.

    • D.

      Pick up any paper on the floor and get the room ready for morning physician rounds.

    Correct Answer
    A. Perform a “down and dirty” assessment on each client soon after receiving report.
    Explanation
    The nurse should explain that completing a "down and dirty" assessment on each client soon after receiving report is the first priority during morning rounds. This type of assessment involves quickly assessing the client's vital signs, general appearance, and any immediate concerns or changes in their condition. By conducting this assessment, the nurse can identify any urgent needs or changes in the client's condition that require immediate attention. This allows the nurse to prioritize care and ensure that any necessary interventions are implemented promptly.

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  • 25. 

    The nurse has received shift report. Which client should the nurse assess first?

    • A.

      The client diagnosed with coronary artery disease complaining of severe indigestion.

    • B.

      The client diagnosed with congestive heart failure who has 3+ pitting edema.

    • C.

      The client diagnosed with atrial fibrillation whose apical rate is 110 and irregular.

    • D.

      The client diagnosed with sinus bradycardia who is complaining of being constipated.

    Correct Answer
    A. The client diagnosed with coronary artery disease complaining of severe indigestion.
    Explanation
    The client diagnosed with coronary artery disease complaining of severe indigestion should be assessed first because severe indigestion could be a symptom of a heart attack. Given the client's diagnosis and the severity of their symptoms, it is important for the nurse to prioritize their assessment and potentially intervene promptly to prevent any further complications.

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  • 26. 

    The client diagnosed with a myocardial infarction (MI) is being discharged. Which discharge instruction(s) should the nurse teach the client?

    • A.

      Call the health care provider (HCP) if any chest pain happens.

    • B.

      Discuss when the client can resume sexual activity.

    • C.

      Explain the pharmacology of nitroglycerin tablets.

    • D.

      Encourage the client to sleep with the head of the bed elevated.

    Correct Answer
    B. Discuss when the client can resume sexual activity.
    Explanation
    The nurse should teach the client about when they can resume sexual activity after a myocardial infarction (MI). This is important because engaging in sexual activity can put strain on the heart, and it is essential for the client to understand when it is safe to do so. By discussing this with the client, the nurse can ensure that they have the necessary information to make informed decisions about their sexual activity and prevent any potential complications.

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  • 27. 

    The nurse is administering morning medications. Which medication should be administered first?

    • A.

      The cardiac glycoside medication, digoxin, toa client diagnosed with heart failure and whohas 2+ edema of the feet.

    • B.

      The sliding scale insulin to a client with afasting blood glucose of 345 mg/dL who isdemanding breakfast.

    • C.

      The loop diuretic, furosemide, to a client witha 24-hour intake of 986 mL and an output of1,400 mL.

    • D.

      The ARB medication to a client whose bloodpressure was reported by the unlicensed assistive personnel as 142/76.

    Correct Answer
    B. The sliding scale insulin to a client with afasting blood glucose of 345 mg/dL who isdemanding breakfast.
    Explanation
    The sliding scale insulin should be administered first because the client's fasting blood glucose level is significantly high at 345 mg/dL. This indicates that the client's blood sugar is not well controlled and immediate intervention is needed to bring it down to a safe level. Administering insulin before breakfast will help regulate the client's blood sugar and prevent potential complications associated with hyperglycemia.

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  • 28. 

    The nurse identifies the concept of tissue perfusion as a client problem. Which is an antecedent of tissue perfusion?

    • A.

      The client has a history of coronary artery disease (CAD).

    • B.

      The client has a history of diabetes insipidus (DI).

    • C.

      The client has a history of chronic obstructive pulmonary disease (COPD).

    • D.

      The client has a history of multiple fractures from a motor-vehicle accident.

    Correct Answer
    A. The client has a history of coronary artery disease (CAD).
    Explanation
    Tissue perfusion refers to the adequate blood flow to the tissues, organs, and cells in the body. Coronary artery disease (CAD) is a condition that affects the blood flow to the heart muscle due to the narrowing or blockage of the coronary arteries. This can lead to inadequate tissue perfusion in the heart, resulting in symptoms such as chest pain or angina. Therefore, a history of CAD can be considered an antecedent or a risk factor for impaired tissue perfusion.

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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Feb 24, 2021
    Quiz Created by
    Catherine Halcomb
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