Kaplan CAT 2 Review questions and answers

Kaplan CAT 2 Review questions and answers 1. Report evidence of "alarm fatigue" among staff to the unit manager. 2. Replace the pump, label the current pump, and send it for repairs. 3. Fill out an incident report, citing the behavior that endangered a client. 4. Approach the nurse and discuss how to handle broken equipment.: 2. Replace the pump, label the current pump, and send it for repairs. Focus the immediate action on the client and the safe use of equipment. Arrange for the replacement or repair of the pump that is alarming continuously. 66. The nurse prepares to administer prescribed amoxicillin to four clients. Which client condition causes the nurse to question the health care provider's prescription for this medication? 1. Lyme disease. 2. Scarlet fever. 3. Hay fever. 4. Syphilis.: 3. Hay fever. Hay fever is not caused by bacteria; therefore, is not treated with amoxicillin. Hay fever is managed with antihistamines and removal of known allergens. 67. The nurse provides care for a client in the final stage of chronic kidney disease. The client's serum calcium level is 7.5 mg/dL (1.8 mmol/L) and the phosphate level is 6.0 mg/dL (1.9 mmol/L). Which priority nursing diagnosis does the nurse use to plan care for this client? 1. Activity intolerance. 2. Risk for injury. 3. Imbalanced nutrition. 4. Failure to thrive.: 2. Risk for injury. The client in the final stage of chronic kidney disease is at risk for osteodystrophy due to bone mineral loss leading to an increased risk for fractures or osteoporosis. Due to this condition, the client is at risk for serious injuries during a fall. 68. The nurse prepares to administer fondaparinux to a client. Which labora- tory test result will the nurse monitor in the client receiving this medication?- : creatinine level Fondaparinux is excreted by the kidneys; creatinine level should be monitored periodically, and the drug stopped in clients who develop unstable kidney function or severe renal impairment. 69. The nurse educator teaches a group of staff nurses about measures to prevent the transmission of healthcare-associated infections when provid- ing care for clients. Which intervention does the nurse educator include in the teaching? (Select all that apply.) 1. Clean stethoscopes between clients. 2. Empty bedpans as soon as possible. 3. Limit fresh flowers in client rooms. 4. Use personal protective equipment (PPE) 5. Perform handwashing and alcohol-based sanitizing.: 1, 4, 5 70. symptoms of lung cancer?: are often vague and present late in the disease late symptoms include constant coughing and bloody sputum 71. The nurse assesses a client with obsessive compulsive personality dis- order. Which finding will the nurse expect to observe? (Select all that apply.) 1. Requires excessive support from others when making decisions. 2. Believes is able to know what others are thinking. 3. Possesses exaggerated feelings of helplessness when alone. 4. Demonstrates unwillingness to delegate tasks unless others follow strict rules. 5. Imposes perfectionism in own completion of tasks.: 4. Demonstrates un- willingness to delegate tasks unless others follow strict rules. 5. Imposes perfectionism in own completion of tasks. 72. to prevent catheter associated UTIs do you want to maintain an open or closed drainage system?: closed 73. can an NAP add up intake and output for each client?: yes 74. has cross reactivity with penicillins: cefazolin (cephalosporins) 75. The nurse is assisting in the care of a client with ventricular fibrillation. The "code" leader called to shock the client uses a biphasic defibrillator. The nurse sets the defibrillator at which energy level?: 120 to 200 joules 76. what is the goal of steriod therapy in metastatic cancer?: palliative reduc- tion of pain 77. The nurse provides care to a client with a total serum calcium level of 7.0 mg/dL (1.75 mmol/L). Which action will the nurse take first?: initiate seizure precautions 78. The nurse uses a paper-based documentation system to write a client care note. The previous nurse's documentation appears incomplete. Which action should the nurse take next?: draw a line through any empty space and continue documenting... empty spaces should not be left because it allows others to document in that space in an incorrect manner 79. The nurse provides care to a school-age child suspected of being sexu- ally abused. Which assessment data best supports this suspicion? 1. Difficulty walking. 2. Bald spots on scalp. 3. Fear of parents. 4. Welts on buttocks.: difficulty walking fear of parent and the others are more likely associated with physical abuse 80. The nurse notes that a client diagnosed with Parkinson disease moves slowly, has difficulty dressing, and experiences bowel and urinary incon- tinence. Which intervention is appropriate for this client? (Select all that apply.) 1. Provide an elevated toilet seat. 2. Make modified clothing without buttons available. 3. Transfer to a skilled nursing facility. 4. Arrange for gait training. 5. Lower the dose of Parkinson medications.: 1,2, 4 there is no indication that a transfer to a snif is needed at this time 81. The nurse provides care for a client newly diagnosed with a benign brain tumor. The nurse teaches the client about the diagnosis. Which property of benign tumors should the nurse include in the teaching? 1. They are poorly differentiated. 2. They metastasize to other organs. 3. They grow at an aggressive rate. 4. They can cause tissue destruction.: 4. They can cause tissue destruction. malignant tumors are poorly differentiated, benign tumors are more differentiated, meaning they more closely resemble the cells of the tissue from which they arose 82. A client relieves severe abdominal pain that radiates to the back by sitting forward with the knees bent. Which laboratory test will the nurse expect to be prescribed for this client? 1. Creatinine. 2. Serum amylase. 3. Creatinine kinase. 4. Blood urea nitrogen.: 2. Serum amylase. amylase is a digestive enzyme secreted by the pancreas. since the client is demonstrating signs of acute pancreatitis 83. severe abd pain that radiates to the back indicates: acute pancreatitis 84. creatinine kinase is used to evaluate?: muscle function 85. The nurse admits a child with fever, malaise, headache, and a vesicular rash on the scalp, face, and trunk. Which transmission-based precaution does the nurse implement for this child?: airborne and contact the client demonstrates varicella infection 86. The nurse develops a teaching plan to promote optimal cardiac output during pregnancy. Which information is most important for the nurse in- clude? 1. Take frequent rest periods between activities. 2. Modify aerobic exercise as pregnancy progresses. 3. Avoid resting or sleeping in the supine position. 4. Elevate both lower extremities whenever sitting.: 3. Avoid resting or sleeping in the supine position. Particularly in second half of pregnancy, the weight of the pregnant uterus com- presses the vena cava (which can lead to maternal hypotension syndrome) and aorta (which can lead to fetal hypoxia). It is a priority to prevent compression of these major vessels. 87. The nurse learns that a client was not prescribed a treatment for a disease process because of age. For which principle violation will the nurse bring this issue to the organization's ethics committee?: justice 88. veracity?: means telling the truth 89. alendronate should be taken with a full glass of water to prevent?: acid reflex 90. measles precautions?: airborne 91. The nurse reviews the medications of a client who reports daily daytime sleepiness. Which medication will the nurse consider as causing this client's sleepiness? 1. Diltiazem. 2. Famotidine. 3. Fenofibrate. 4. Duloxetine.: 4. Duloxetine. 92. when it says wear opaque clothing and hat outside...that is good and means protecting from sun: okay 93. A client with a gastric feeding tube is prescribed metoprolol XL 50 mg by mouth twice daily. Which action will the nurse take when providing this medication? 1. Crush the medication and administer via nasogastric tube. 2. Have the client swallow the pill with a sip of water. 3. Call the health care provider. 4. Call the pharmacy to ask for a different form of metoprolol.: call HCP the pharmacy cannot change a med order 94. can an NAP administer a tap water enema for a colonscopy in 2 hours?- : no 95. A client who is pregnant is prescribed a medication that is pregnancy cat- egory D. Which statement does the nurse make to the client when explaining this drug category?: "Studies indicate that a possible fetal risk in humans has been reported." 96. A client who is pregnant is prescribed a medication that is pregnancy cat- egory X. Which statement does the nurse make to the client when explaining this drug category?: reports indicate fetal abnormalities occur 97. The nurse provides care to clients on a progressive care unit. Which client does the nurse see first? 1. The client recovering from a transjugular intrahepatic portosystemic shunt (TIPS) procedure. 2. The client who received subcutaneous insulin to treat a blood glucose of 317 mg/dL. 3. The client newly diagnosed with systemic lupus erythematosus (SLE). 4. The client receiving continuous octreotide infusion to treat portal hyper- tension.: 1. The client recovering from a transjugular intrahepatic portosystemic shunt (TIPS) procedure. After a TIPS procedure the client is at risk for bleeding. This client's clotting factors are likely to be altered due to liver dysfunction. The procedure shunts blood away from esophageal varices and requires an assessment by the nurse. 98. The nurse provides care for a very low birth weight (VLBW) preterm newborn receiving oxygen therapy. The nurse assesses the infant for which complication of oxygen therapy? 1. Nonshivering thermogenesis. 2. Hyperbilirubinemia. 3. Polycythemia. 4. Retinopathy of prematurity.: 4. Retinopathy of prematurity. Visual impairment or blindness in preterm infants, especially VLBW, due to injury of developing retinal blood vessels is sometimes precipitated by high levels of oxygen. 99. The nurse auscultates heart sounds in a school-age client. Where does the nurse place the stethoscope to listen to the aortic area of the heart? 1. Second left intercostal space. 2. Second right intercostal space. 3. Fifth intercostal space, left midclavicular line. 4. Fifth right and left intercostal spaces.: 2. Second right intercostal space. 100. The nurse follows up with a client diagnosed with insomnia. The nurse seeks to determine if treatment was successful. Which response by the client best indicates treatment was successful? 1. "I am sleeping 4 hours a night." 2. "I fall asleep within 1 to 2 hours at night now." 3. "I am not napping in the day anymore." 4. "I am waking up twice a night.": 3. "I am not napping in the day anymore." 101. A client asks for an explanation about advance directives. Which entity should the nurse include in the response to this client? (Select all that apply.) 1. Living will. 2. Health care proxy. 3. Organ donor card. 4. Hospice benefit guide. 5. Do-not-resuscitate prescription.: 1, 2, 5 102. A client takes a statin as prescribed. Which action does the nurse implement to identify if the client is experiencing any side effects of the medication? 1. Measure height and weight. 2. Check recent cholesterol level. 3. Inquire about the consistency of stool. 4. Assess for muscle tenderness.: assess for muscle tenderness myalgia or muscle tenderness may indicate development of rhabdomyolysis, which is an adverse reaction to statin meds monitoring cholesterol evaluates the effectiveness of the med. not the side effects 103. The nurse assesses a client diagnosed with heart failure. The nurse's findings include a heart rate of 126 beats/min and an altered level of con- sciousness. Which action should the nurse take next? 1. Assess the client for jugular distention. 2. Evaluate the client's peripheral pulses. 3. Administer the prescribed diuretic medication. 4. Notify the health care provider of the status change.: 1. assess the client for JVD Assessing jugular distention based on the client's heart failure diagnosis imme- diately gives the nurse additional assessment information regarding the source of the change in mental status. 2) After jugular distention, peripheral pulses are examined for presence and strength to determine the degree of the client's perfusion issue, which is also evidenced by the change in mental status. 3) When the client is exhibiting changes easily attributable to fluid overload and a diuretic is ordered and available, the nurse should give the diuretic. This action as- sumes the nurse has established there are no accompanying signs of cardiogenic shock or pulmonary embolus. 4) The nurse should notify the health care provider of the status change after the assessment is complete. 104. slow recoil of the pinna is seen in ?: preterms less than 34 weeks the ear has little cartilage to keep it stiff. It will remain folded over or return slowly when folded longitudinally and horizontally. In a full- or post-term neonate, the ear springs back to the original position immediately. 105. absence of plantar creases?: Full- and post-term neonates have deep plantar creases. A preterm newborn has few creases on the foot.