1. A client on telemetry has a pattern of uncontrolled atrial fibrillation with a
rapid ventricular response. Based on this finding, the nurse
... [Show More] anticipates
assisting the physician with which treatment?
A. Administer lidocaine, 75 mg intravenous push.
B. Perform synchronized cardioversion.
C. Defibrillate the client as soon as possible.
D. Administer atropine, 0.4 mg intravenous push.
Rationale:
With uncontrolled atrial fibrillation, the treatment of choice is synchronized
cardioversion to convert the cardiac rhythm back to normal sinus rhythm.
Option A is a medication used for ventricular dysrhythmias. Option C is not for
a client with atrial fibrillation; it is reserved for clients with life-threatening
dysrhythmias, such as ventricular fibrillation and unstable ventricular
tachycardia. Option D is the drug of choice in symptomatic sinus bradycardia,
not atrial fibrillation.
2.A practical nurse (PN) tells the charge nurse in a long-term facility that she
does not want to be assigned to one particular resident. She reports that the male
client keeps insisting that she is his daughter and begs her to stay in his room.
What is the best managerial decision?
A. Notify the family that the resident will have to be
discharged if his behavior does not improve.
B. Notify administration of the PN's insubordination
and need for counseling about her statements.
C. Ask the PN what she has done to encourage the
resident to believe that she is his daughter.
D. Reassign the PN until the resident can be assessed
more completely for reality orientation.
Rationale:
Temporary reassignment is the best option until the resident can be examined
and his medications reviewed. He may have worsening cerebral dysfunction
from an infection or electrolyte imbalance. Option A is not the best option
because the family cannot control the resident's actions. The administration may
need to know about the situation, but not as a case of insubordination. Implying
that the PN is somehow creating the situation is inappropriate until a further
evaluation has been conducted.3.Client census is often used to determine staffing needs. Which method of
obtaining census determination for a particular unit provides the best formula
for determining long-range staffing patterns?
A. Midnight census
B. Oncoming shift census
C. Average daily census
D. Hourly census
Rationale:
An average daily census is determined by trend data and takes into account
seasonal and daily fluctuations, so it is the best method for determining staffing
needs. Options A and B provide data at a certain point in time, and that data
could change quickly. It is unrealistic to expect to obtain an hourly census, and
such data would only provide information about a certain point in time.
4.The nurse is counseling a healthy 30-year-old female client regarding
osteoporosis prevention. Which activity would be most beneficial in achieving
the client's goal of osteoporosis prevention?
A. Cross-country skiing
B. Scuba diving
C. Horseback riding
D. Kayaking
Rationale:
Weight-bearing exercise is an important measure to reduce the risk of
osteoporosis. Of the activities listed, cross-country skiing includes the most
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