Health Assessment Proctored Exam( Texas University)

When a client's serum sodium level is 120 mEq/L, the priority nursing assessment is to monitor the status of which body system?

The client has a serum potassium level of 3.1 mEq/L. What is a priority intervention?

A client is being seen for chest congestion, coughing up thick secretions, and shortness of breath for several days and is diagnosed with pneumonia. The client has a one-pack-per-day smoking habit. Wh

A nurse is educating a home care client on how to do pursed-lip breathing. What is the therapeutic effect of this procedure?

A nurse is preparing to assess the oxygen saturation level of a client with a history of peripheral vascular disease using pulse oximetry. The nurse plans to apply the sensor to the client's right ind

A client is post op day 1 for a right knee replacement. The client has severe pain that impairs the ability to walk safely. Which nursing diagnosis takes priority?

The nurse is caring for a client who has been NPO for 5 days with a nasogastric tube to suction. What nursing intervention takes priority?

The nurse is caring for a client with a surgically debrided wound, which the surgeon has left open to drain and will delay closure for the time being. The nurse understands that this type of intention

There is one client on a mechanical soft diet who needs help with food tray set-up. A second client received pain medication 30 minutes ago, is a fall risk, and requires ambulation assistance to the b

The Registered Nurse makes the following request to an UAP staff: "Please get a blood sugar on the client in room 652 before 0730 this morning and report the results back to me if below 70 or above 30

A client with a Stage II pressure injury on the sacrum is most likely to present with which finding?

A nurse is caring for a client with COPD (chronic obstructive pulmonary disease) who is receiving 4 liters of oxygen via nasal cannula. The oxygen saturation is 86% and continues to decrease. What sho

A nurse has provided care to a client. Which entry is written correctly?

The following arterial blood gas (ABG) results indicate? pH-7.58 PaCO2-37.5 Pa02-80 HCO3-31.2 BE-(+6.4) 02 Sat - 93%

Which of these client scenarios is most indicative of critical thinking?

When a client's status begins to decline, the nurse contacts the provider to discuss the situation. The nurse ends the conversation by proposing to decrease the IV fluids and obtain a chest x-ray. Wha

The operating surgeon is explaining a complex surgical procedure as a treatment option before obtaining consent. The nurse notices the client is having a hard time understanding the terminology and is

Which electrolyte imbalance does kayexalate (sodium polysteyrene) treat?

The nurse is caring for a client with a stage 4 pressure wound of the buttocks. What interventions should be included in the plan of care? Select all that apply.

The nurse is concerned about a client with an increasing respiratory rate now at 24. Which action by the nurse reflects data gathering and clinical reasoning?

The nurse is caring for a client with respiratory acidosis. Approximately how long will it take for the renal system to compensate (to see a change in the pH) for this disorder?

A 92 year old stroke client cannot speak. Which action would assist in communicating with this client?

The following arterial blood gas (ABG) results indicate? pH-7.13 PaCO2-38.8 mmHg PaO2-83 mmHg HCO3-13.2 mEq/L BE-(-14.5) O2 Sat-95%

Identify the defining characteristic in the following nursing diagnosis statement: Altered speech related to recent neurological disturbance as evidenced by inability to speak in complete sentences:

The following arterial blood gas (ABG) results indicate? pH-7.68 PaCO2-30 mmHg Pa02-81 mmHg HCO3-16.2 mEq/L BE-(+21.2) 02 Sat-91%