A client with severe pulmonary edema secondary to heart failure needs to have their circulating volume/preload and afterload decreased quickly. Knowing pharmacological properties of these drugs, the nurse anticipates that the provider will order which of the following medication combinations for the client?

The nurse going off duty gives report on the following clients to the nurse coming on duty. Which client should the on-duty nurse assess first?

The nurse provides instructions to a client newly diagnosed with type 1 diabetes mellitus. The nurse recognizes accurate understanding of measures to prevent diabetic ketoacidosis when the client makes which statement?

The oncology unit nurse is caring for a client with a large thoracic tumor (see picture). The nurse will monitor closely for the occurrence of which signs or symptoms of a developing complication? (Select all that apply.)

Early detection of spinal cord compression is essential for prompt intervention and preventing loss of function. The most common presenting symptom of spinal cord compression in clients with cancer is:

A 55-year-old client is admitted with an acute inferior-wall myocardial infarction. During the admission interview, he says he stopped taking his metoprolol 5 days ago because he was feeling better. Which priority problem is most important to initiate for this client?

The nurse is conducting a preoperative assessment and interview on a client who is scheduled for elective surgery today. The client has a history of morbid obesity, diabetes, hypertension, and atrial fibrillation. The client reports taking insulin, metoprolol, and warfarin every day. What priority information will the nurse obtain from the client to ensure safety during the intraoperative period?

An older adult client with type 2 diabetes is brought to the emergency department by his daughter. The client is found to have a blood glucose level of 623 mg/dL. The client's daughter reports that the client recently had a gastrointestinal virus and has been confused for the last 3 hours. The diagnosis of hyperglycemic hyperosmolar syndrome (HHS) is made. What nursing action would be a priority?

The nurse is caring for an 86-year-old who has just been admitted with acute pulmonary edema. The client arrived on your unit with oxygen at 3 liters per nasal cannula and a saline lock in place. The client's oxygen saturation is 94% currently. Which ordered intervention has the highest priority?

To evaluate a client following cardiac catheterization with a left upper arm insertion site, the nurse should palpate the:

A client is being treated with chemotherapy for small cell lung cancer. The client's recent lab values demonstrate a serum sodium of 132 mEq/L (Normal range 135-145 mEq/L). What is the likely initial treatment for the low sodium?

A nurse is caring for a 16-year-old who is in the hospital with advanced stage cancer. The client's mother states, "His father has such poor coping skills; all he does is keep working overtime at the business." The nurse offers the following appropriate response:

A nurse is caring for a client following surgery that was done with a spinal anesthetic. The client complains of a severe headache. What nursing intervention should the nurse carry out first?

Which is the priority nursing diagnosis upon first encountering a client experiencing diabetic ketoacidosis?

The preop nurse has only a short time to teach the client before they go to the operating room. Which priority information is appropriate for the nurse to teach to the client? (Select all that apply.)

The provider prescribed cefazolin 2 grams in 100 mL D5W IV piggyback to infuse over 45 minutes. The drop factor on the tubing is 15gtts/mL. How fast will the nurse regulate this IV in gtts/min (round to nearest whole number, no labels)?

A PACU nurse receives report on a client following a major surgery. The client was classified as an ASA 2 status with a previous history of mild asthma and Type Il diabetes. Upon initial assessment, the nurse notes that the client is somnolent, responsive to voice, and complains of pain. The client has expiratory wheezes, the Jackson Pratt (JP) drain bulb is 1/2 full of bloody drainage, and the client's blood glucose is 212. Vital signs are: HR 85 RR 8 BP 160/90 02 sat 90% on 2L oxygen per nasal cannula. The nurse's initial action will be:

Which of the following clients would the nurse expect to transfer immediately to the cardiac catheterization cab (cath lab)?

The client underwent a six-hour surgical procedure. A Foley catheter was placed at the beginning of the operation and it was removed at the end of the case. The client arrives in the PACU at 1400. What will the recovery room nurse report to the nurse on the post-surgical floor when giving the hand-off report?

The nurse is caring for a client who has had a 12-lead ECG. The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip. How should the nurse best respond?

The nurse is caring for a post-operative client who was just returned to his room from the PACU after abdominal surgery. The client has been settled in bed, a nasal cannula applied at 2 liters/minute, and the RN has auscultated the chest. What is the nurse's next priority?

The order reads: "Place nasogastric (NG) tube to low intermittent suction. Measure NG tube fluid loss every 4 hours. Replace the volume lost over the next 4 hours with IV normal saline solution." The nurse measures 150 mL in the NG collection container over the last four hours. What IV rate would the nurse program the pump for to deliver the 4 hour replacement? (round to nearest whole number, no labels)

A new nurse is being precepted by a nurse in the ICU. The client was admitted with DKA and is on an insulin drip using a prescribed insulin drip protocol. Which statement by the new nurse indicates a need for further instruction by the preceptor?

Prior to receiving hand-off report on a client, the nurse reads in the client's chart that the client is being treated for tumor lysis syndrome. The nurse will anticipate that the following therapies will be included in the care of the client: (Select all that apply.)

The nurse is planning care for a client who is admitted with fever and absolute neutrophil count (ANC) of 500 (normal range 1500-5000) several days post chemotherapy and radiation for metastatic colorectal cancer. The nurse should include which of the following restrictions in the client's plan of care?

The client is in the recovery room following chest surgery. The client complains of severe nausea and starts retching (gagging; dry heaves). What should the nurse do next?

A nurse is caring for a client who has just returned from a cardiac catheterization procedure using the right femoral site. Which nursing interventions should the nurse include in the client's plan of care for the next 8 hours? (Select all that apply.)

The preoperative admitting nurse notices that the client scheduled for surgery in two hours has a smell of alcohol on his breath even though he stated that he has fasted since midnight. What is the nurse's best first action?

The nurse is preparing the client for surgery. Prior to obtaining the client's signature on the operative consent form, the nurse asks the client if she understands the surgical procedure. The client replies that she is very nervous and does not understand the procedure on the form. What action will the nurse take?

While at the scrub sink, the circulating nurse notices that the scrub tech is wearing artificial nails. The scrub tech defends the artificial nails saying that her own nails break easily and pose a risk for glove puncture. What is the circulating nurse's best response?

The postoperative client has a Penrose drain. The nurse caring for the client will correctly manage the drain with which actions?

A nurse observes mild hand tremors in an alert client who has diabetes mellitus. Which of the following actions should the nurse take after obtaining a glucose meter reading of 60 mg/dL?

A diagnosis of hyperglycemic hyperosmolar state (HHS) is made for a client with type 2 diabetes who is brought to the emergency department with a blood glucose of 856 mg/dL. Which of the following interventions would be appropriate for this client? (Select all that apply.)

A nurse is admitting a client to the surgical unit from the PACU following a cholecystectomy. Which assessment is the nurse's priority?

A nurse is preparing to administer furosemide 20 mg IV push. Prior to administering the medication, the nurse attempts to flush the peripheral venous access device and finds that the IV does not flush easily. What is the most appropriate intervention in this situation?

The nurse is watching the ECG monitor and notices that a client's rhythm has changed to the following rhythm. (Vfib)

A nurse is caring for an adolescent client who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which type of IV insulin to treat this client?

A pediatric nurse is depressed and having trouble empathizing with clients after the death of several young clients over the course of several months. What action is the most appropriate response to the nurse's own distress?

The nurse on the medical/surgical unit is admitting a client from the PACU. What is the first assessment the nurse will perform on a newly admitted client?

A client is demonstrating signs of anaphylaxis minutes after the second cycle of paclitaxel is initiated. As the chemotherapy nurse gets ready to administer emergency medications, which action should the nurse do first?

The nurse is caring for a client with cancer who is scheduled for surgery to debulk the size of a spinal tumor that is causing pain. How would this client's surgical procedure be classified?

The nurse is concerned that a client is experiencing diabetic ketoacidosis. Which findings did the nurse discover in the client to come to this conclusion? (Select all that apply.)

The nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include a fasting blood glucose level of 120 mg/dL (6.8 mmol/L), temperature of 101.3 °F (38.5°C), pulse of 102 beats/minute, respirations of 22 breaths/minute, and blood pressure of 142/72 mmHg. Which finding would be the priority concern to the nurse?

The order is for 3g magnesium sulfate IV bolus over 30 minutes. It is supplied in 40 g magnesium sulfate in 1000 mL of normal saline. What rate will the nurse set the pump for the bolus dose? (Whole number, no labels)

Which action is the first priority of care for the client with a history of coronary artery disease who is exhibiting signs and symptoms of chest pain and shortness of breath?

Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis?

The drug book states the recommended dose of ondansetron is 0.15mg/kg. The ondansetron is packaged as 2 mg/mL. Calculate the correct dose in mg to be given IVP for a 242-pound adult (round to one decimal place, no labels).

A client with atrial fibrillation has been unresponsive to anti-arrhythmic drug therapy and attempts at electrical cardioversion for several days. Of the following options, which intervention must be initiated next in treating this client's unresponsive heart rhythm?

A medical/surgical nurse is aware of the need to screen specific patients for their risk of hyperglycemic hyperosmolar syndrome (HHS). In which client population does HHS most often occur?

The nurse is caring for a client who has developed obvious signs of pulmonary edema. What is the priority nursing action?

The nurse is planning care of a client with cancer who was admitted with a fever. The client has the following blood counts: WBC 2300/mL (normal range: 5000-10,000) Absolute neutrophil count (ANC) of 800 (normal range 1500-5000) Hemogobin 7.2 g/dL (normal range 12-16 g/dL) Platelets 98,000 cells/mm3 (normal range 150,000-400,000. Which collaborative treatment will the nurse administer as a priority?

A client arrives unconscious via ambulance to the emergency department. The client's Medic Alert bracelet indicates that the client has type 1 diabetes. The client's blood glucose is currently 22 mg/dL (1.2 mmol/L). The nurse should anticipate which priority intervention?

A nurse is educating a client about self-care while dealing with cancer. The nurse will cover the symptoms of hypercalcemia, which are the following:

A child is admitted to the pediatric oncology unit with a significant thrombocytopenia noted in the initial CBC with a platelet count of less than 50,000 cells/mm3 (normal range 150,000-400,000 for children). The hematologist is ordering more work up to determine a medical diagnosis. Which teaching points are relevant for the nurse to include in the plan of care? (Select all that apply.)

The nurse at the oncology infusion center is teaching a client what to expect after their chemotherapy treatment. The nurse will clarify information when the client states the following: