The Free 14 Days Questions

Free preview · Original latest version

Sample questions from The Free 14 Days Questions

This material has 60 questions with answers and rationales. Here are the first 5.

1. 1.A 68-year-old client on a medical unit becomes restless and short of breath. Respirations are 30/min, SpO2 is 84% on room air, and crackles are heard bilaterally. Which action should the nurse take first?

   • A.Raise the head of the bed and apply oxygen.
   • B.Obtain a complete medication history.
   • C.Measure intake and output for the shift.
   • D.Teach the client to restrict dietary sodium.

   Rationale: Positioning upright and applying oxygen immediately address impaired oxygenation. A medication history and intake and output assessment are useful but do not correct the immediate threat. Sodium teaching is appropriate after stabilization. The exam takeaway is to address breathing before routine assessment or education.

2. 2.A 74-year-old client with pneumonia is admitted to an emergency department. Temperature is 39.1 C, heart rate is 124/min, blood pressure is 82/46 mm Hg, and lactate is 4.8 mmol/L. The client has new confusion and no signs of fluid overload. Which prescribed action has the highest immediate priority?

   • A.Collect a sputum specimen.
   • B.Administer an isotonic crystalloid bolus.
   • C.Administer oral acetaminophen.
   • D.Review the client's vaccination history.

   Rationale: Hypotension, elevated lactate, and altered mental status indicate severe hypoperfusion requiring prompt fluid resuscitation. Sputum collection supports targeted treatment but must not delay stabilization or antibiotics. Acetaminophen improves comfort, and vaccination review supports prevention, but neither restores perfusion. Recognize shock and prioritize circulation.

3. 3.A 59-year-old client arrives at a stroke center 50 minutes after developing right arm weakness and difficulty speaking. Blood pressure is 168/92 mm Hg, glucose is 112 mg/dL, and SpO2 is 96%. Which action should the nurse anticipate next?

   • A.Administer oral aspirin before imaging.
   • B.Lower systolic blood pressure below 120 mm Hg.
   • C.Obtain an emergency noncontrast head CT.
   • D.Offer water to evaluate swallowing.

   Rationale: A noncontrast head CT rapidly distinguishes hemorrhagic from ischemic stroke and guides treatment. Aspirin should not precede exclusion of intracranial bleeding. Abruptly lowering this blood pressure can compromise cerebral perfusion, and oral water is unsafe before a swallowing screen. Time-sensitive stroke assessment precedes oral intake and definitive drug selection.

4. 4.A 62-year-old client in an emergency department reports crushing chest pressure radiating to the jaw. The ECG shows ST elevation in contiguous leads, blood pressure is 134/78 mm Hg, and SpO2 is 97% on room air. While the reperfusion team is activated, which prescription should the nurse implement promptly?

   • A.Apply oxygen at 6 L/min routinely.
   • B.Delay medications until troponin results return.
   • C.Encourage the client to walk to reduce anxiety.
   • D.Administer chewable aspirin if there is no contraindication.

   Answer and rationale are in the full material.

5. 5.A 66-year-old client receiving chemotherapy presents to an oncology clinic with chills. Temperature is 38.5 C, heart rate is 112/min, blood pressure is 104/64 mm Hg, and the absolute neutrophil count is 300/mm3. Which action is most appropriate?

   • A.Obtain ordered cultures promptly and initiate prescribed broad-spectrum antibiotics without delay.
   • B.Recommend acetaminophen and reassessment at home tomorrow.
   • C.Wait for a second fever before notifying the provider.
   • D.Perform a rectal temperature measurement to confirm the fever.

   Answer and rationale are in the full material.