Capstone Midterm

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Sample questions from Capstone Midterm

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

1. 1.A nurse receives report on four clients. Which client should the nurse assess first?

   • A.A client with chronic heart failure who has bilateral ankle edema
   • B.A client 2 hours after thyroidectomy who is restless and has inspiratory stridor
   • C.A client with diabetes whose premeal glucose is 248 mg/dL
   • D.A client with a urinary tract infection who reports dysuria

   Rationale: Stridor and restlessness after thyroidectomy suggest airway obstruction, which requires immediate assessment and intervention. The edema, hyperglycemia, and dysuria require follow-up but do not indicate the same immediate threat to airway or breathing. Use the ABC priority framework when selecting the client to assess first.

2. 2.A client with COPD is receiving oxygen at 2 L/min by nasal cannula. The client becomes increasingly drowsy and has a respiratory rate of 8/min. What should the nurse do first?

   • A.Increase oxygen to 6 L/min
   • B.Assess airway and breathing and stimulate the client
   • C.Place the client supine and recheck in 30 minutes
   • D.Remove the oxygen and leave the client to rest

   Rationale: A respiratory rate of 8/min with declining alertness signals possible respiratory failure, so the nurse should immediately assess ventilation and responsiveness and summon help as indicated. Increasing oxygen alone does not correct inadequate ventilation, while delaying reassessment or removing oxygen is unsafe. Prioritize assessment and rapid escalation for acute respiratory deterioration.

3. 3.A client with heart failure is prescribed furosemide. Which laboratory result is most important for the nurse to report before administering the dose?

   • A.Potassium 2.9 mEq/L
   • B.Sodium 138 mEq/L
   • C.Calcium 9.2 mg/dL
   • D.Hemoglobin 13.4 g/dL

   Rationale: Furosemide can worsen potassium loss, and a potassium of 2.9 mEq/L increases the risk of dysrhythmias. The sodium, calcium, and hemoglobin values are within expected ranges and do not present the same immediate medication-related concern. Check electrolytes and report significant hypokalemia before giving a loop diuretic.

4. 4.A nurse is preparing to administer digoxin to an adult client. The apical pulse is 54/min. What is the best action?

   • A.Administer the medication and reassess in 1 hour
   • B.Hold the dose and notify the health care provider
   • C.Give the dose with food to reduce adverse effects
   • D.Ask the client to walk and then recheck the pulse

   Answer and rationale are in the full material.

5. 5.A client with suspected stroke has facial droop and slurred speech. Which action is most important before giving oral medications?

   • A.Check the client's blood glucose
   • B.Obtain a swallow screen
   • C.Place the client in a supine position
   • D.Ask the client to cough forcefully

   Answer and rationale are in the full material.