Hondros NUR 245

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Sample questions from Hondros NUR 245

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

1. 1.In the emergency department, a 6-year-old with a history of asthma has worsening work of breathing. The chart shows increasing retractions and SpO2 falling from 94% to 89% on room air. Refer to the client's chart. Which actions should the nurse take now? Select all that apply.

   • A.Delay treatment until a chest radiograph is obtained
   • B.Reassess work of breathing and oxygen saturation frequently
   • C.Place the client supine and encourage sleep
   • D.Apply oxygen and titrate to the prescribed target
   • E.Administer the prescribed inhaled short-acting bronchodilator

   Rationale: Oxygen, prompt bronchodilator treatment, and frequent reassessment address the worsening hypoxemia and respiratory distress documented at 1000. Supine positioning can impair ventilation, and treatment should not be delayed for imaging when the client is deteriorating. Stabilization takes priority over diagnostic testing.

2. 2.At change of shift on a medical unit, a 72-year-old client with pneumonia has a temperature of 38.4 C, HR 108, RR 26, BP 112/68, and SpO2 91% on 2 L/min nasal oxygen. Which client should the nurse assess first?

   • A.A client with pneumonia whose oxygen saturation is falling
   • B.A client with diabetes whose premeal glucose is 12.2 mmol/L and who has no symptoms
   • C.A client with chronic arthritis requesting an analgesic
   • D.A client awaiting discharge instructions after an uncomplicated procedure

   Rationale: The pneumonia client's hypoxemia and tachypnea indicate impaired oxygenation and possible deterioration, requiring immediate assessment. Pain and discharge needs are important but can wait while an unstable respiratory problem is addressed. An asymptomatic glucose elevation requires follow-up, but is less urgent than falling oxygenation.

3. 3.During a home health visit, a 58-year-old client with a new ileostomy reports dizziness. The client has dry mucous membranes, HR 112, BP 94/60, and 1.8 L of watery output since morning. Which action is the priority?

   • A.Encourage a high-fiber meal to thicken the output
   • B.Teach the client to reduce oral fluids until output decreases
   • C.Document the output and revisit the client tomorrow
   • D.Assess hydration and notify the provider about the high output and hypotension

   Rationale: High ileostomy output with dizziness, tachycardia, hypotension, and dry mucosa suggests significant fluid volume depletion. The nurse should assess promptly and report the findings for treatment. Restricting fluids worsens dehydration, and waiting or relying on dietary changes delays needed care.

4. 4.A 44-year-old client with a new prescription for warfarin is preparing for discharge from a clinic. The client asks how the dose will be adjusted. Which response by the nurse is best?

   • A.Use aspirin for pain without consulting the prescriber
   • B.The dose is adjusted using your INR results and clinical situation
   • C.Take an extra dose whenever you eat leafy green vegetables
   • D.Stop the medication once bruising disappears

   Answer and rationale are in the full material.

5. 5.On a pediatric inpatient unit, a 9-year-old with type 1 diabetes is vomiting and has abdominal pain. The chart shows glucose rising to 19.4 mmol/L and deep respirations. Refer to the client's chart. Which actions should the nurse take? Select all that apply.

   • A.Withhold all insulin until the child eats a full meal
   • B.Notify the provider promptly about suspected diabetic ketoacidosis
   • C.Check ketones as prescribed and report the result
   • D.Encourage sugar-free fluids only and wait several hours before reassessing
   • E.Continue the prescribed insulin plan while clarifying any uncertainty with the provider

   Answer and rationale are in the full material.