Wolter Kluwers

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Sample questions from Wolter Kluwers

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 68-year-old client is 2 hours postoperative after a total hip arthroplasty. The client suddenly reports shortness of breath and chest pain. Respirations are 30/min, oxygen saturation is 86% on room air, pulse is 124/min, and blood pressure is 92/58 mm Hg. Which action should the nurse take first?

   • A.Apply oxygen and activate the rapid response team
   • B.Assist the client to ambulate to improve circulation
   • C.Administer the prescribed oral analgesic
   • D.Document the findings and reassess in 30 minutes

   Rationale: The sudden hypoxemia, chest pain, tachycardia, and hypotension suggest a potentially life-threatening pulmonary embolism; oxygen and rapid escalation are priorities. Ambulation could worsen the client's instability. An oral analgesic does not address the immediate threat, and delaying action to document or reassess is unsafe. The exam takeaway is to stabilize airway and breathing and summon help for acute deterioration.

2. 2.A 74-year-old client with heart failure is admitted with increasing dyspnea. The client is sitting upright, has crackles bilaterally, and has an oxygen saturation of 88% on room air. Which action should the nurse take first?

   • A.Place the client in high-Fowler position and apply prescribed oxygen
   • B.Obtain a daily weight before intervening
   • C.Encourage oral fluids to loosen secretions
   • D.Place the client flat and elevate the legs

   Rationale: Upright positioning and oxygen support breathing while the nurse continues urgent assessment and treatment. A daily weight is useful for monitoring fluid status but does not address current hypoxemia. Additional oral fluids may worsen congestion, and lying flat can increase respiratory distress. The exam takeaway is to address immediate breathing problems before routine monitoring.

3. 3.A 56-year-old client arrives at the emergency department with facial droop and slurred speech that began 40 minutes ago. Blood glucose is 112 mg/dL, and vital signs are stable. Which action should the nurse take first?

   • A.Activate the facility's stroke response process
   • B.Give aspirin before obtaining brain imaging
   • C.Offer water to assess swallowing
   • D.Lower the blood pressure to below 120/80 mm Hg

   Rationale: Time-sensitive stroke evaluation is essential, so the nurse should activate the stroke response process immediately. Aspirin is not given before hemorrhage has been excluded by imaging. Oral fluids are unsafe until swallowing is assessed, and rapid blood pressure reduction is not appropriate without a specific order or indication. The exam takeaway is to recognize stroke symptoms and expedite evaluation while protecting the client from aspiration.

4. 4.A 70-year-old client with type 1 diabetes is pale and diaphoretic and reports confusion. Blood glucose is 48 mg/dL; the client is awake and can swallow. Which action should the nurse take?

   • A.Give 15 g of a fast-acting oral carbohydrate
   • B.Administer the scheduled rapid-acting insulin
   • C.Give a high-protein snack only
   • D.Keep the client NPO and recheck glucose in 1 hour

   Answer and rationale are in the full material.

5. 5.A 63-year-old client with diabetic ketoacidosis has a glucose of 520 mg/dL, potassium of 5.4 mEq/L, and blood pressure of 88/54 mm Hg. Which prescription should the nurse implement first?

   • A.Begin the prescribed isotonic intravenous fluid bolus
   • B.Start the regular insulin infusion immediately
   • C.Administer potassium chloride intravenously
   • D.Give sodium bicarbonate intravenously

   Answer and rationale are in the full material.