1 A nurse is assessing for early signs of compartment syndrome for a client who has a

short-leg fiberglass cast. Which of the following findings should the nurse expect?

ACapillary refill less than 2 seconds

B.Bounding distal pulses

C.Intense pain with movement

D. Erythema of the toes

2 A nurse is monitoring a client who is receiving 2 units packed RBCs. Which of the

following manifestations indicates a hemolytic transfusion reaction?

A.Chills? (think fever, you get cold when your body is hot)

B. Hypertension

C.Bradycardia

D.Back pain

3 A nurse is caring for a client who had a total hip arthroplasty. Which of the following

actions should the nurse take to prevent hip dislocation?

A.Remove the wedge device when turning

B. Place two bed pillows between the legs when in bed

C. Encourage the client to lean forward when attempting to stand

D.Elevate the knees higher than the hips when sitting

4 A nurse is assessing a client who is preoperative and reports an allergy to bananas.

The nurse should recognize that the client is at risk for an allergic cross-reactivity to

which of the following substances

A.Povidone-iodine

B.Adhesive tape

C.Latex

D. Anesthetics

5 A nurse is teaching a client about the use of an incentive spirometer. Which of the

following instructions should the nurse include in the teaching?

APlace hands on the upper abdomen during inhalation.

B.Position the mouthpiece 2.5 cm (1 in) from the mouth

C. Exhale slowly through pursed lips

D. Hold breaths about 3 to 5 seconds before exhaling

6 A nurse is caring for a client who arrives at the emergency department and reports

vomiting and diarrhea for the past 3 days. The client's serum potassium level is

2.8mEqttiL. Which of the following interventions should the nurse implement first?

Priority question remember, what can I do first, you can start a K+ drip without knowing

how their heart is affected.

A. Check the clients hand grasps