Joseph Jackson

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Sample questions from Joseph Jackson

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

1. 1.Joseph Jackson, age 68, is admitted to the medical unit with pneumonia. He is newly confused, has a temperature of 39.1 C (102.4 F), heart rate 124/min, respiratory rate 30/min, blood pressure 86/50 mm Hg, and oxygen saturation 90% on room air. Which action should the nurse take first?

   • A.Apply oxygen and immediately activate the rapid response system
   • B.Obtain a sputum specimen before starting treatment
   • C.Administer the prescribed acetaminophen
   • D.Encourage oral fluids and reassess in 30 minutes

   Rationale: The hypotension, tachycardia, fever, and altered mentation suggest sepsis with impaired perfusion, requiring immediate escalation and support of oxygenation. A sputum specimen and acetaminophen may be appropriate later but must not delay urgent care; oral fluids and delayed reassessment are unsafe with this instability. The exam takeaway is to recognize deterioration and prioritize immediate life-threatening problems.

2. 2.Joseph Jackson, age 72, is recovering from a stroke on a rehabilitation unit. He has right-sided weakness, coughs after sipping water, and has an oxygen saturation of 95% on room air. Which action is best before giving oral medication?

   • A.Crush the medication and mix it with applesauce
   • B.Keep him NPO and request a swallowing evaluation
   • C.Give the medication with a straw while he sits upright
   • D.Ask his family whether he usually swallows pills easily

   Rationale: Coughing with liquids after a stroke signals possible dysphagia and aspiration risk, so oral intake should be withheld pending evaluation. Crushing medication may be unsafe and does not prevent aspiration; a straw can worsen swallowing difficulty, and family history does not establish current safety. The exam takeaway is to protect the airway before administering anything orally.

3. 3.Joseph Jackson, age 55, is receiving a heparin infusion for a pulmonary embolism in the intensive care unit. His aPTT is 118 seconds, and he reports a new severe headache; vital signs are blood pressure 168/94 mm Hg and heart rate 88/min. Which action should the nurse take?

   • A.Continue the infusion and repeat the aPTT in 6 hours
   • B.Stop the infusion and notify the provider immediately
   • C.Give the next scheduled warfarin dose
   • D.Encourage ambulation to reduce clot burden

   Rationale: A markedly prolonged aPTT with a new severe headache raises concern for bleeding, including intracranial hemorrhage, so the infusion should be stopped and the provider notified urgently. Continuing heparin or adding warfarin increases bleeding risk, while ambulation does not address the possible emergency. The exam takeaway is to respond promptly to signs of anticoagulant-associated bleeding.

4. 4.Joseph Jackson, age 64, with type 2 diabetes is admitted to the emergency department with nausea and dehydration. His glucose is 548 mg/dL, potassium is 5.6 mEq/L, blood pressure is 94/58 mm Hg, and heart rate is 116/min. Which prescribed intervention should the nurse implement first?

   • A.Begin isotonic IV fluid replacement
   • B.Administer IV regular insulin
   • C.Give oral potassium chloride
   • D.Restrict fluids until the glucose decreases

   Answer and rationale are in the full material.

5. 5.Joseph Jackson, age 45, is admitted to the hospital with asthma exacerbation. He is using accessory muscles, speaks one word at a time, has a respiratory rate of 34/min, and has an oxygen saturation of 88% despite 2 L/min nasal oxygen. Which action is the priority?

   • A.Administer the prescribed rapid-acting inhaled bronchodilator
   • B.Teach pursed-lip breathing
   • C.Obtain a peak expiratory flow measurement
   • D.Offer warm oral fluids

   Answer and rationale are in the full material.