BSN 366 129 Questions

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Sample questions from BSN 366 129 Questions

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

1. 1.At change of shift on a medical-surgical unit, a 68-year-old client with pneumonia has a temperature of 38.2 C, HR 104, RR 24, BP 118/70, and SpO2 91% on 2 L/min by nasal cannula. Which client should the nurse assess first?

   • A.A client with pneumonia whose SpO2 has fallen from 95% to 91% despite supplemental oxygen
   • B.A client with a urinary tract infection who has a temperature of 38.0 C and is due for an oral antibiotic
   • C.A client with diabetes whose premeal glucose is 224 mg/dL and who is awaiting a prescribed correction dose
   • D.A client 1 day after abdominal surgery who reports incisional pain of 7/10 and has a respiratory rate of 18/min

   Rationale: The falling oxygen saturation despite supplemental oxygen signals worsening respiratory status and requires prompt assessment. Postoperative pain needs treatment, but the reported respiratory rate is stable and there is no cue of immediate airway compromise. The elevated glucose and fever require timely care but are less urgent than deteriorating oxygenation. Prioritize an emerging threat to breathing over stable or anticipated problems.

2. 2.During a home health visit, a 74-year-old client with heart failure says, "I cannot afford all these pills, so I take my water pill every other day." The client has mild ankle edema, BP 146/82, HR 88, and SpO2 95% on room air. Which action should the nurse take first?

   • A.Notify the health care provider that the client is nonadherent to the prescribed regimen
   • B.Ask the client to describe medication costs and barriers to obtaining the prescribed drugs
   • C.Instruct the client to take the diuretic daily regardless of cost
   • D.Arrange for a family member to supervise all medication administration

   Rationale: The nurse should first assess the specific financial and practical barriers before collaborating on a safe, achievable plan. Notifying the provider may be appropriate after clarifying the situation, but it does not replace assessment. Directing daily use without addressing affordability is unlikely to resolve the problem and may be unrealistic. Family supervision should not be imposed without assessing the client's preferences and available supports.

3. 3.Refer to the client's chart. The client is being transferred from the emergency department to a pediatric unit. Which actions should the nurse take to support a safe handoff? Select all that apply.

   • A.Ask the receiving nurse to review the chart later instead of giving a verbal handoff
   • B.Include the time and amount of the last albuterol treatment in the handoff
   • C.Confirm that the receiving unit is prepared to provide the ordered oxygen and monitoring
   • D.Communicate the change in respiratory status and the oxygen support currently required
   • E.Send the client's medication list and allergy information with the transfer documentation

   Rationale: The chart shows increased work of breathing and a recent oxygen requirement, so the receiving nurse needs the respiratory trend and current support. The time and amount of the last albuterol treatment help prevent missed or duplicated therapy, and medication and allergy information are essential transfer details. Confirming the receiving unit's readiness helps ensure continuity of ordered oxygen and monitoring. Relying only on later chart review omits direct, timely communication during a transfer.

4. 4.In a long-term care facility, an 82-year-old resident with a documented health care proxy is alert and tells the nurse, "I do not want this procedure." The resident's adult child insists that the procedure proceed. Which action should the nurse take?

   • A.Ask the adult child to sign the consent because the child is the closest relative
   • B.Ask the health care proxy to make the decision while the resident is alert
   • C.Proceed because the procedure has already been scheduled by the provider
   • D.Pause preparation and notify the provider that the resident is refusing the procedure

   Answer and rationale are in the full material.

5. 5.The parent of a 4-year-old seen at a community clinic requests that the nurse tell the preschool that the child has a new diagnosis of epilepsy. The parent has not signed a release, and no immediate safety threat is present. What is the nurse's best response?

   • A.Call the preschool director because the diagnosis could affect classroom safety
   • B.Share the diagnosis with the child's teacher but not with other preschool staff
   • C.Explain that written authorization is needed before sharing the child's health information
   • D.Send the diagnosis by secure email because the preschool is responsible for the child during the day

   Answer and rationale are in the full material.