Chamberlain

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Sample questions from Chamberlain

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

1. 1.A 68-year-old client in the emergency department has pneumonia, new confusion, BP 82/46 mm Hg, HR 124/min, RR 30/min, and lactate 4.6 mmol/L. Oxygen and IV access have been established, and the sepsis protocol is activated. Which prescribed intervention should the nurse initiate first?

   • A.Administer acetaminophen for a temperature of 39.1 C.
   • B.Begin the prescribed IV isotonic crystalloid bolus.
   • C.Collect a clean-catch urine specimen.
   • D.Review the client's pneumococcal vaccination history.

   Rationale: Hypotension, altered mentation, and elevated lactate indicate impaired tissue perfusion, making immediate fluid resuscitation the priority among these actions. Acetaminophen treats discomfort but does not reverse shock. Urine collection and vaccination review must not delay stabilization. Prioritize circulation while completing the time-sensitive sepsis bundle.

2. 2.A 74-year-old client on a telemetry unit has heart failure and takes furosemide and digoxin. Before administering scheduled digoxin, the nurse notes nausea, yellow halos around lights, an apical pulse of 48/min, and potassium of 2.9 mEq/L. What should the nurse do first?

   • A.Give digoxin with food to reduce nausea.
   • B.Administer the medication and reassess the pulse in 1 hour.
   • C.Hold digoxin and promptly notify the prescribing clinician.
   • D.Encourage a potassium-rich snack and continue scheduled medications.

   Rationale: Bradycardia, visual changes, and nausea suggest digoxin toxicity, and hypokalemia increases this risk. Giving digoxin with food or waiting until after administration could worsen toxicity. Dietary potassium alone is insufficient for symptomatic hypokalemia and possible drug toxicity. Hold the unsafe dose and obtain prompt evaluation, including rhythm and laboratory assessment.

3. 3.A 59-year-old client arrives at a stroke center 50 minutes after sudden right-arm weakness and difficulty speaking. BP is 178/96 mm Hg, glucose is 106 mg/dL, and oxygen saturation is 96% on room air. Which action should the nurse prioritize after activating the stroke alert?

   • A.Give oral aspirin before further testing.
   • B.Arrange immediate noncontrast CT of the head.
   • C.Lower systolic BP to less than 120 mm Hg.
   • D.Perform a water-swallow test before transport.

   Rationale: Rapid noncontrast CT distinguishes hemorrhage from ischemia and guides time-sensitive treatment. Aspirin should not precede exclusion of intracranial hemorrhage. Abruptly lowering BP to this target can compromise cerebral perfusion, and swallowing assessment must not delay imaging. Maintain nothing-by-mouth status until swallowing safety is established.

4. 4.A 23-year-old client in the emergency department has diabetic ketoacidosis with glucose 518 mg/dL, pH 7.18, potassium 3.1 mEq/L, and BP 96/58 mm Hg. Isotonic IV fluids are infusing. Which prescribed action should the nurse question?

   • A.Continue cardiac monitoring.
   • B.Measure glucose every hour.
   • C.Administer prescribed IV potassium replacement.
   • D.Start the IV regular insulin infusion immediately.

   Answer and rationale are in the full material.

5. 5.A 66-year-old client hospitalized with an exacerbation of chronic obstructive pulmonary disease is alert but dyspneic, with RR 28/min and oxygen saturation 84% on room air. Which action is most appropriate?

   • A.Withhold oxygen until arterial blood gas results are available.
   • B.Apply controlled supplemental oxygen and titrate initially to 88%-92%.
   • C.Apply a nonrebreather mask with the goal of maintaining 100% saturation indefinitely.
   • D.Coach pursed-lip breathing without administering oxygen.

   Answer and rationale are in the full material.