A nurse reviews the laboratory data for an older patient. The nurse would be most concerned about which finding?
a. Hematocrit of 35
b. Hemoglobin of 11.8 g/dL
c. Platelet count of 400,000/L
d. White blood cell (WBC) count of 2800/L
Question 2The nurse assesses a patient who has numerous petechiae on both arms. Which question should the nurse ask the patient?
a. Do you take salicylates?
b. Are you taking any oral contraceptives?
c. Have you been prescribed antiseizure drugs?
d. How long have you taken antihypertensive drugs?
Question 3Which finding in a patient hospitalized with bronchiectasis is most important to report to the health care provider?
a. Cough productive of bloody, purulent mucus
b. Scattered rhonchi and wheezes heard bilaterally
c. Respiratory rate 28 breaths/minute while ambulating in hallway
d. Complaint of sharp chest pain with deep breathing
Question 4The nurse is caring for a patient who is being discharged after an emergency splenectomy following an automobile accident. Which instructions should the nurse include in the discharge teaching?
a. Watch for excess bruising.
b. Check for swollen lymph nodes.
c. Take iron supplements to prevent anemia.
d. Wash hands and avoid persons who are ill.
Question 5A patient with asthma has a personal best peak expiratory flow rate (PEFR) of 400 L/minute. When explaining the asthma action plan, the nurse will teach the patient that a change in therapy is needed when the PEFR is less than ___ L/minute
Fill in the blank with the appropriate word.
Question 6The nurse receives a change-of-shift report on the following patients with chronic obstructive pulmonary disease (COPD). Which patient should the nurse assess first?
a. A patient with loud expiratory wheezes
b. A patient with a respiratory rate of 38/minute
c. A patient who has a cough productive of thick, green mucus
d. A patient with jugular venous distention and peripheral edema
Question 7The nurse reviews the medication administration record (MAR) for a patient having an acute asthma attack. Which medication should the nurse administer first?
a. Albuterol (Ventolin) 2.5 mg per nebulizer
b. Methylprednisolone (Solu-Medrol) 60 mg IV
c. Salmeterol (Serevent) 50 mcg per dry-powder inhaler (DPI)
d. Triamcinolone (Azmacort) 2 puffs per metered-dose inhaler (MDI)
Question 8The clinic nurse makes a follow-up telephone call to a patient with asthma. The patient reports having a baseline peak flow reading of 600 L/minute and the current peak flow is 420 L/minute. Which action should the nurse take first?
a. Tell the patient to go to the hospital emergency department.
b. Instruct the patient to use the prescribed albuterol (Proventil).
c. Ask about recent exposure to any new allergens or asthma triggers.
d. Question the patient about use of the prescribed inhaled corticosteroids.
Question 9Which nursing action for a patient with chronic obstructive pulmonary disease (COPD) could the nurse delegate to experienced unlicensed assistive personnel (UAP)?
a. Obtain oxygen saturation using pulse oximetry.
b. Monitor for increased oxygen need with exercise.
c. Teach the patient about safe use of oxygen at home.
d. Adjust oxygen to keep saturation in prescribed parameters.
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