After shift change, a nurse takes over care for a postpartum client who had been bleeding moderately and is staying on the labor unit for closer watching. What assessment finding should the nurse be the most concerned about?

The nurse is caring for a client who is 32 weeks pregnant and diagnosed with disseminated intravascular coagulation. Which of the following lab values does not support the client’s diagnosis?

A nurse is caring for a 6-year-old child who has severe vitamin C deficiency. The nurse notes that the child’s skin has areas of purpura. This condition of most likely described as which of the following?

A nurse is caring for a client with a gastric ulcer who begins to have active bleeding. Which of the following is the priority nursing intervention?

A nurse is assessing a postpartum client who has a platelet count of 47,000 uL, D-dimer of 0.59 and a PT of 3 seconds. What findings would the nurse expect to assess?

A client with difficulty breathing gets a CT scan that shows multiple clots in the lungs as well as in the heart and kidneys. Which blood clotting condition does this client most likely have?

A nurse is caring for a client that delivered a fetal demise 3 hours ago is bleeding heavily. The providers believe she has disseminated intravascular coagulation and has ordered labs to be drawn. What results would the nurse expect to see if DIC is occurring? Select all that apply.

A client has an order to receive one unit of fresh-frozen plasma (FFP). Based on the nurse’s understanding of this blood product, the nurse knows that which of the following are true regarding FFP? Select all that apply.

A nurse is preparing to give blood products to a client who is experiencing excess bleeding after surgery. Prior to administration, which action should the nurse perform first?

A nurse is caring for a postpartum client with disseminated intravascular coagulation. The client’s family wants to understand what this means. What is the best response by the nurse?

The nurse is caring for a client with thrombocytopenia. Which of the following substances would the nurse expect to administer for this client?

A nurse has an order to administer heparin to a client. Which steps would the nurse take to minimize the risk of the client developing heparin-induced thrombocytopenia (HIT)? Select all that apply.

A client who is receiving heparin for a history of blood clots has developed heparin-induced thrombocytopenia. His platelet count is 90,000/mcL. Which of the following nursing interventions is most appropriate in this situation?

A nurse is caring for a client with essential thrombocythemia. What diagnostic finding will the nurse expect to see?

The nurse is caring for a client with immune thrombocytopenic purpura. Which of the following interventions would the nurse expect to employ?

A client presents to the emergency department with thrombocytopenia. Likely nursing interventions include which of the following? Select all that apply.

A nurse is reviewing the consent form for a blood transfusion for a client. Which of the following risks would the nurse need to explain as part of receiving a blood transfusion? Select all that apply.

A nurse is administering a blood product to a client in the recovery room. She has explained the procedure and possible complications to the client and obtained consent. She has obtained baseline vital signs and confirmed the client’s identity using two identifiers. She has checked the product and compared it with the identity of the client with another RN. The client has a patent IV and the set is ready to be administered with normal saline solution. The nurse starts the transfusion. Which of the following interventions does the nurse perform next?

A client who is recovering from a hip replacement is receiving a blood transfusion in the recovery room. Following the start of the infusion, the client develops a hemolytic reaction. During a hemolytic reaction, the client would most likely experience which of the following?

A client with an AB- blood type needs a whole blood transfusion in the emergency department. Which type of blood could this client receive from a donor? Select all that apply.

A nurse recognizes that the last two clients who received blood products developed some form of transfusion reaction. Which of the following steps could the nurse perform that would most likely prevent a transfusion reaction in the next client? Select all that apply.

The blood bank has sent a unit of whole blood for a client to receive while he is staying in the hospital. Which of the following describes a type of serologic testing that the blood bank has most likely performed on this unit of blood? Select all that apply.

A client who is receiving a blood transfusion has developed symptoms of circulatory overload. Which of the following nursing interventions are most appropriate in this situation? Select all that apply.

Which best describes the purpose of the type and crossmatch blood test?

A nurse has been ordered to administer one unit of packed red blood cells to a client who is in the pre-op holding room. The nurse notes that the client has not signed consent for blood products yet. Which of the following elements must the nurse consider when obtaining informed consent for blood product administration? Select all that apply.

A nurse has an order to administer cryoprecipitate to a client. Which of the following is an indication for administering this type of blood product? Select all that apply.

A client has been admitted to the hospital for surgery. The client has a history of leukemia and has developed septicemia. Which of the following situations is this client most likely at risk for?

A nurse is administering platelets to a client with leukemia. After completing the transfusion, the nurse should document which information?

A 68-year-old client is being treated for leukemia, but his prognosis is very grim. The client asks the nurse about how he is doing. Which statement from the nurse is most appropriate?

A nurse is caring for a client with leukemia who is undergoing chemotherapy. The nurse is educating the client’s family on what to expect throughout treatment. Which statement by the family would demonstrate understanding of education?

A nurse has an order to administer IVIG to a client with leukemia. Which of the following is a true statement regarding this type of blood product? Select all that apply.

A client with leukemia will go home with a Groshong catheter placed in the right subclavian vein to use for long-term administration of chemotherapy. Which information would the nurse provide to the client regarding care of the Groshong catheter at home? Select all that apply.

The oncology nurse is caring for a client with leukemia. The nurse knows that the purpose of chemotherapy in this client is for which reason?

A nurse is caring for a client who has a history of leukemia. The client’s body is demonstrating systemic inflammatory response syndrome (SIRS). Which of the following signs or symptoms would the nurse see with SIRS? Select all that apply.

A nurse is performing the initial assessment of a child with a history of acute leukemia who was brought into the emergency department. The nurse discovers the child has a temperature of 38.5C. Which action is the first priority in this situation?

A client with leukemia is being discharged from the hospital and is going home with an infection. Which precautions would the nurse teach the client to implement at home that would best prevent him from transmitting the infection?

A 78-year-old client is being admitted to the hospital for surgery. The client has a history of lymphoma that has returned twice after undergoing chemotherapy treatments, and has a DNR order in place in case of cardiac arrest. What is a true statement regarding a DNR order? Select all that apply.

A nurse is working with a family whose mother is dying of lymphoma. Which information would the nurse give to the family about respite care that is accurate?

A client who has recovered from cancer surgery requires lymphedema therapy. Which best describes an activity that would occur with this type of therapy?

A client with lymphoma is preparing to undergo a bone marrow transplant. The client will be using bone marrow taken from their own body. Which type of transplant is this referred to?

The nurse is working on an oncology unit with a client who is currently receiving chemotherapy, and is finishing a bed bath. What is the priority?

The nurse is caring for a client with breast cancer who underwent radiation therapy four weeks ago. The nurse should tell the client to look for what potential late effects of radiation therapy following the treatment? Select all that apply.

The nurse is teaching a female client about breast self examination (BSE). The client asks where a lump is most likely to be found. Which location would be the most accurate response by the nurse?

A client with a spinal tumor has been having a difficult time sleeping. Which best explains how a tumor can make sleep more difficult for a client with cancer?

A 48-year-old client has been diagnosed with pancreatic cancer. The client asks the nurse, “How could this have happened to me?!” Which of the following has been shown to be a risk factor for development of pancreatic cancer? Select all that apply.

A client with cancer has just had a Portacath placed by outpatient surgery. The nurse is discharging this client to go home. Which of the following instructions would the nurse give to this client about care of a Portacath? Select all that apply.

A 63-year-old female client complains of urinary retention and an inability to empty her bladder. The nurse understands that the client is likely experiencing which of the following conditions? Select all that apply.

The nurse is caring for a client who has recently finished chemotherapy. The client asks if it is appropriate to begin exercising. Under which conditions would exercise be contraindicated for this client? Select all that apply.

A 37-year-old client with pancreatic cancer is experiencing chemotherapy-induced nausea and vomiting (CINV) after his latest round of medication. Which drug would most likely be prescribed for the control of CINV?

A client is preparing to undergo a radical prostatectomy. During the pre-operative visit, the client asks the nurse, “When do I get to eat again?” Which response from the nurse is accurate?

The nurse is caring for a client with AIDS. While checking routine vital signs, the nurse notes a temperature of 37.8 C. The nurse understands that which of the following is true?

The nurse is caring for a client with AIDS. The nurse enters the room prepared to do an assessment, take vital signs, and give scheduled medications. After performing these nursing interventions, the nurse assists the client into the shower and changes the client’s linens while the client sits on the shower bench. Which of the following describes the most appropriate reasoning behind this?

A nurse is providing instructions and information to a client who has been recently diagnosed with HIV. What information would the nurse include as part of teaching this client about appropriate management of this condition? Select all that apply.

Which best describes the viral load of HIV in the body?

The nurse is assessing a client with advanced AIDS. Which of the following are expected findings? Select all that apply.

A nurse in the infectious diseases unit of the hospital is caring for a client who has been diagnosed with HIV infection. The nurse understands that this client is considered to have developed AIDS with which of the following conditions? Select all that apply.

The nurse caring for a client with advanced HIV progressing to AIDS. Which of the following conditions would not be associated with AIDS?

A client has been infected with HIV for 5 years. Which of the following would require a change in the client’s diagnosis from being HIV-positive to having AIDS?

A nurse is caring for a client with AIDS. The client informs the nurse about the client’s use of acupuncture to help with the pain. The nurse should be most concerned about this practice due to which of the following factors?

A nurse is administering human immunodeficiency virus testing at a community screening event. When providing education, which of the following will the nurse use to classify the disease?

The nurse is caring for a client who is having an anaphylactic reaction. The provider has placed orders. Which of the following orders is the priority?

A 9-year old child is brought to the emergency room in anaphylactic shock. Which of the following medication orders would be the most appropriate for this child?

A nurse is caring for a client whose friend brings cupcakes to the hospital. After taking a bite, the client’s face and neck begin to turn red and the client’s lips start to swell. The client begins grabbing their throat as the client’s mother reports a nut allergy. The nurse quickly retrieves Epinephrine 1:1,000. Which route is the appropriate route to administer this medication?

45 minutes after receiving a transfusion of whole blood, a client develops an anaphylactic transfusion reaction. During this reaction, the nurse would most likely expect to see:

The nurse is caring for a client who was started on lisinopril at the beginning of the shift. The nurse notes that the client’s tongue seems a bit swollen and their speech sounds “thick”. What is the nurse’s priority?

A client is rushed to the emergency department after a peanut exposure and subsequent anaphylactic reaction. The nurse prepares to administer epinephrine. Which concentration and route should the nurse utilize?

While eating dinner in a restaurant, a customer develops an anaphylactic reaction. A nurse nearby notices the problem and stops to help. The first action of the nurse should be which of the following?

The emergency nurse is managing care for an assigned group of clients. The nurse receives a new admission that is becomes the priority. Which of the following is the priority?

A pregnant client suffers from a pollen allergy and is being seen for management of symptoms. The nurse is teaching the client about how best to prevent an allergic reaction. Which of the following statements by the nurse is most appropriate?

The nurse is caring for a client who is starting a long-term regimen of glucocorticoids for adrenal insufficiency. Which of the following teaching points is appropriate for the nurse to include when educating the client on this medication? Select all that apply.

The nurse walks into a client’s room and notices that their skin is a dark bronze color. The nurse knows this could indicate which of the following diseases?

The nurse is caring for a client with Addison disease. Which of the following manifestations of this condition should the nurse expect? Select all that apply.

What structure is circled in yellow in this image?

A nurse is caring for a client who has been diagnosed with Addison’s disease. The nurse is teaching about symptoms of Addisonian crisis in order to best manage and prevent it before it occurs. What symptoms should the client look for that the nurse should include as part of teaching? Select all that apply.

A provider has prescribed hormone replacement therapy for a client who has Addison’s disease. The nurse who is caring for this client understands the difference between Addison’s disease and Cushing’s syndrome as which of the following?

A client is experiencing an adrenal crisis due to Addison’s Disease. Which of the following would NOT be a priority nursing intervention for this client?

The client needs replacement of the hormones necessary for the regulation of fluid and electrolyte balance within the body. Which hormones will the nurse expect to replace? Select all that apply.

A client is newly diagnosed with Addison’s disease. The nurse understands that this condition includes a decrease of which of the following hormones? Select all that apply.

A client is admitted to the hospital with primary adrenal insufficiency. Which of the following drugs does the nurse anticipate giving for this condition? Select all that apply.

A client is suffering from excess cortisol excretion as a result of an adenoma on the pituitary gland. Which of the following changes is an expected finding in a client with this condition? Select all that apply.

Which of the following electrolyte imbalances is an expected finding for a client with Cushing’s Syndrome? Select all that apply.

The nurse is working with a client who has been diagnosed with Cushing’s syndrome. The nurse has provided teaching about the disease process and management. Which of the following statements by the client demonstrates a need for additional teaching?

The nurse is caring for a client with Cushing syndrome. The nurse knows to perform which daily activity?

The nurse is performing an admission assessment on a client and notes that the client has a moon-shaped face. The nurse understands that this could indicate which of the following?

A 79-year-old client with Cushing’s disease has developed some cognitive effects that are impacting his ability to care for himself. Which cognitive effects are most likely to develop in a client with Cushing’s disease?

A client reports pain at an intravenous site. What assessment findings would indicate phlebitis? Select all that apply.

A nurse is caring for a client who has been diagnosed with Cushing’s syndrome. The client is at risk of impaired skin integrity related to skin dryness and edema. Which of the following goals would be most appropriate for this client?

The nurse is caring for a client with Cushing’s syndrome. The nurse knows that this disease is caused by hypersecretion of which of the following hormones? Select all that apply.

A client with Cushing’s syndrome has become more withdrawn from friends and relatives because of changes in appearance. Upon admission to the healthcare center, the nurse gives the client a nursing diagnosis of Social Isolation related to discomfort with others and feelings of rejection by other people. Which of the following nursing interventions is most appropriate in this situation?

A client with diabetes insipidus must start taking vasopressin. Which information from the nurse is correct when providing teaching about this medication?

The nurse is caring for a client with diabetes insipidus and is preparing to administer a scheduled vasopressin injection. Which of the following is an anticipated outcome for a client with diabetes insipidus receiving this drug?

A nurse suspects a client has diabetes insipidus. What are the priority interventions? Select all that apply.

A client who has been diagnosed with diabetes insipidus has been prescribed vasopressin as an antidiuretic replacement. The nurse caring for the client reviews his other medications. Which drug should not be taken with vasopressin?

A client who has suffered a traumatic brain injury (TBI) has developed diabetes insipidus. A home health nurse is seeing the client in his home to help him manage his care at home. Which of the following teaching points would the nurse offer to help prevent injury in this client?

A nurse is caring for a client is being treated for SIADH with 3% hypertonic saline to correct a serum sodium of 129 mEq/L, which was drawn approximately 24 hours ago. A new BMP shows the latest sodium is 147 mEq/L. What is the priority nursing intervention at this time?

A nurse is caring for a client who has been diagnosed with syndrome of inappropriate anti-diuretic hormone (SIADH). What type of electrolyte imbalance would the nurse most likely see in this situation?

The floor nurse is reviewing lab results for a client with syndrome of inappropriate antidiuretic hormone (SIADH) and notes a sodium level of 132 mEq/L. The nurse continues to monitor the client closely for which of the following abnormal signs/symptoms?

A client has been diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following is NOT a priority nursing intervention for this client?

The neuro ICU nurse is caring for a client with head trauma and subsequent syndrome of inappropriate antidiuretic hormone (SIADH). The nurse notes confusion and muscle weakness, and correctly understands that which of the following is occurring?

A client is being tested for Graves’ disease. The nurse knows that which one of the following lab panels would be used to rule out this condition?

A nurse is caring for a client who has just returned from a thyroidectomy. What would be the most appropriate position for this client?

A 40-year-old female client with recent thyroid surgery has been admitted to the hospital with a fever, tremors, profuse sweating, and anxiety. Based on this client’s symptoms, which drug class would be a priority to give to this client?

A nurse is caring for a client is undergoing a parathyroidectomy. Which potential risks must the nurse consider when caring for this client following surgery?

The nurse is reviewing the shift assignments and notes one of the clients has Grave’s disease. The nurse knows the client with Grave’s disease could potentially exhibit which of the following?

A client is scheduled to receive a fine needle aspiration of the thyroid gland for a biopsy. Which best describes how the nurse would teach the client about this procedure?

A client has been brought to the emergency department suffering from thyroid storm. Which of the following signs or symptoms would the nurse expect to see in this situation?

A client is taking antithyroid medication. The nurse knows that this medication is taken for which of the following conditions? Select all that apply.

A client has a TSH level of 5.23 mIU/L and a T4 of 3.4 ug/dL. What signs and symptoms would the nurse expect to assess? Select all that apply.

A 45-year-old client is preparing to undergo a thyroidectomy for a tumor on the thyroid gland. The nurse provides a decision aid tool for the client as part of surgery. Which best describes how a decision-making tool aids in the process of informed consent?

The client is newly diagnosed with Hashimoto’s thyroiditis. The client does not fully understand the disease so which of the following explanations should the nurse provide to the client about Hasmioto’s thyroiditis?

A nurse is teaching a patient about his new prescription for levothyroxine (Synthroid). Which of the following should the nurse tell the patient about taking this drug correctly? Select all that apply.

A client has complaints of being tired all the time, weight gain, and that she can’t seem to get warm enough to be comfortable. Which of the following tests would the nurse expect to see ordered to determine a diagnosis for the client? Select all that apply.

Which of the following are signs and symptoms that a client with hypothyroidism would demonstrate? Select all that apply.

A 40-year-old client has thyroid dysfunction and is working with a nurse to determine what lifestyle changes will help this condition. The nurse mentions that vitamins A and D may help to regulate thyroid production. Which of the following foods could the nurse suggest for the client?

A 36-year-old client has developed hypothyroidism after having part of her thyroid removed because of a large nodule. The provider has ordered levothyroxine (Synthroid) for thyroid replacement and has been titrating the dose over several months to ensure that it is effective. Which of the following factors would most likely require an increase in titration of the dosage of this medication?

A client’s lab results revealed increased TSH. The nurse knows this means that the body is trying to tell the thyroid to produce more thyroid hormones. Which of the following medication would have increased the production of thyroid hormone?

The nurse is reviewing a client’s medications from home and notes that levothyroxine is listed as a daily medication. The nurse knows that which of the following times is best to take this medication?

The nurse is admitting a client with newly diagnosed hypothyroidism receiving Synthroid. Which of the following items would the nurse expect to be monitored with this client? Select all that apply.

A nurse is caring for a client who has just returned from a thyroidectomy. What would be the most appropriate position for this client?

A client arrives at the healthcare clinic for diagnostic testing for diabetes. After reviewing the test results, the provider diagnoses the client with prediabetes. Which information from the nurse would be appropriate to teach this client about prediabetes?

A client with neuropathy is being discharged home. The nurse is providing discharge education on which of the following medications for neuropathy?

A 41-year-old client has been diagnosed with type 2 diabetes. The nurse is teaching the client about how to perform self-monitoring of blood glucose (SMBG) at home. The nurse instructs the client about how to use a lancet to obtain a blood sample. Which technique would the nurse most likely include?

A nurse is counseling a client who has hypertension and type 2 diabetes. During the initial assessment, the nurse notes that the client has a blood pressure of 148/92 mmHg, a BMI of 28, and a blood glucose level of 161 mg/dL. Which of the following information about health and wellness would be most beneficial for the nurse to teach this client?

You are working telephone triage for an after-hours family medicine clinic. A patient has called who is diabetic and been sick for the last 3 days with a cold. Which of the following symptoms reported by the patient is the LEAST concerning?

A 38-year-old client has been diagnosed with type 2 diabetes and must take injectable insulin to manage the disease. The nurse is teaching the client about how to inject insulin and the client becomes very upset and anxious at the thought of giving herself an injection. Which response from the nurse is most appropriate?

A nurse is caring for a client that has just been diagnosed with Type II Diabetes. Which of the following would NOT be an appropriate education topic regarding foot care for this newly diagnosed client?

A client with a history of diabetes has a blood sugar of 54 mg/dL. They are conscious and awake, but feel cold and clammy, diaphoretic, weak, and slightly confused. Which of the following is NOT an appropriate intervention at this time?

A client with type II diabetes is not following the treatment regimen. Which of the following medications does the nurse anticipate this client will begin taking to help control blood glucose levels?

Which best describes how high stress levels can impact diabetes management?

The nurse providing education to a client who is newly diagnosed with diabetes mellitus. Which of the following should the nurse emphasize? Select all that apply.

The nurse is teaching foot and skin care to a client with diabetes. Which of the following education points is appropriate?

The nurse is caring for a client with poorly managed diabetes mellitus. The nurse is planning education for this client. Which statement by the client indicates a need for more education?

A nurse is caring for a client who has diabetes and has developed hypoglycemia. Which vital signs would be most consistent with this condition?

A client is admitted with diabetic ketoacidosis (DKA). The nurse knows that which of the following IV fluids should be expected for the healthcare provider to order?

A client admitted with diabetic ketoacidosis (DKA) is very upset and concerned because a family member recently had to have an amputation due to diabetes complications. The client asks what can be done to prevent amputation. Which of the following is the best response by the nurse? Select all that apply.

A nurse is caring for a client who has developed diabetic ketoacidosis. The client has a breathing pattern in which he takes rapid and very deep breaths with large tidal volumes. Which of the following best describes this type of breathing?

A nurse in the intensive care unit (ICU) is caring for a client with diabetic ketoacidosis (DKA). Which of the following is NOT a priority nursing intervention for this client?

A nurse is working with a client who is brought in the emergency department with abdominal pain and dehydration. His glucose level is 388 mg/dL and he has positive serum ketones. Based on theses symptoms and lab values, which action would the nurse expect to perform first?

The nurse is caring for a client in diabetic ketoacidosis (DKA). What is the first nursing action for this client?

A nurse is caring for a client with a diagnosis of diabetic ketoacidosis. Which pH level would be consistent with this diagnosis?

A client with altered mental status and fruity breath has been brought into the emergency department. Which of the following is the priority for the nurse to monitor?

The nurse is caring for a client with diabetic ketoacidosis (DKA). The client suddenly becomes confused. Which of the following actions should the nurse perform first?

The nurse working in the emergency department is receiving report. Out of the following group of clients, which would the nurse be concerned about developing hypovolemic shock?

A nurse is working with a client brought to the emergency department in a comatose state after developing hyperosmolar hyperglycemic syndrome (HHS). The nurse ensures the client’s airway is patent and vital signs are stable. What is the nurse’s next priority in this situation?