NR 224 Week 8 Comprehensive Final Exam

A nurse is removing personal protective equipment (PPE) after performing a procedure for a client who requires isolation precautions. Which of the following items of PPE should the nurse remove first? Gloves Gown Eyewear Mask A nurse is admitting a client who has manifestations that suggest tuberculosis. Which of the following actions is the nurse’s priority? a.Initiate airborne precautions Administer antimicrobial therapy Tell the client that the infection will be communicable for 2-3 weeks from the start of medication therapy Teach the client about the manifestations of tuberculosis The nurse records the following subjective data in the client’s medical record: Breath sounds clear to auscultation Amber urine in sufficient quantities c.Pain intensity 8 out of 10 d.Skin warm and dry A nurse is providing teaching to a client about a surgical procedure for later in the day. The client states that no one has spoken to her about the procedure before. Which of the following action should the nurse take? Continue the teaching, but check afterward with the surgeon about informed consent b.Stop the teaching and check with the surgeon about informed consent Stop the teaching and ask the client to sign an informed consent form Continue the teaching and check the client’s medical record afterward for a signed consent form A nurse is planning care for a patient going to surgery. Who is responsible for informing the patient about the surgery along with possible risks, complications, and benefits? Family member b.Surgeon Nurse Nurse manager A nurse is reviewing informed consent with a client for a cardiac catheterization. Which of the following is the responsibility of the nurse? Explaining the procedure to the client Offering alternative treatments Informing the client of the consequences of refusing the procedure Verifying the client’s understanding of the procedure being performed A nurse is taking a client’s vital signs. Which of the following findings should the nurse identify as outside the expected reference range? Pulse rate 90/min Rectal temperature 38℃ (100.4℉) Pulse oximetry 95% d.BP 145/90 mmHg A nurse is obtaining vital signs from a client. Which of the following findings is the priority for the nurse to report to the provider? Oral temperature 37.8℃ (100℉) b.Respirations 30/min BP 148/88 mmHg Radial pulse rate 45 beats/30 seconds A nurse is caring for a client who has a new prescription for levothyroidism. Which of the following findings should the nurse identify as an indication that the client requires intervention? Heart rate 106/min Dry skin Oral temperature 36.8℃ (98.2℉) Lethargy A nurse is assessing the vital signs of a 1-month-old infant. Which of the following actions should the nurse perform? Use a cuff to auscultate blood pressure Determine heart rate by taking the radial pulse Count respirations before taking other vital signs Measure temperature by placing the thermometer in the infant’s ear A nurse is preparing to assess an 11-month-old infant during a well-child examination. Which of the following actions should the nurse take? Pull the infant’s pinna up and back when examining the ears Palpate and