NCLEX Practice Set 9 (Case Study #3)
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Question 1 of 6
1. Question
Case Study Question 1 of 6
The emergency room nurse is admitting a 55-year-old male who presents with dyspnea, chest pain, and a cough.
Nurse Notes:
Notes Time 1000. Client reports symptoms started almost a week ago, and he was diagnosed with an upper respiratory infection by his primary care physician. Reports worsening dyspnea since yesterday. Has a productive cough sometimes tinged with blood. Complains of chills. Has intermittent chest pain when he breathes deeply. Pain 0/10 at present. Appears restless but can speak in full sentences. No known drug allergies.
Vital Signs Blood pressure = 100/65
RR = 28
Pulse = 110bpm
Temp= 100.8 degrees FahrenheitNeurologic Awake alert and oriented x 3. Cardio-respiratory HR regular rhythm, rales and rhonchi heard on auscultation, productive cough. Oxygen saturation 90% on room air. Gastrointestinal Abdomen soft, nontender. Denies nausea, vomiting, diarrhea, constipation Extremities Warm to touch, no edema Social Assessment Smokes 1 pack a week. Denies alcohol use. Lives independently at home. >Select the answer below that correctly highlights all the findings that require immediate follow-up.
CorrectIncorrect -
Question 2 of 6
2. Question
Case Study Question 2 of 6
The emergency room nurse is admitting a 55-year-old male who presents with dyspnea, chest pain, and a cough.
Nurse Notes:
Notes Time 1000. Client reports symptoms started almost a week ago, and he was diagnosed with an upper respiratory infection by his primary care physician. Reports worsening dyspnea since yesterday. Has a productive cough sometimes tinged with blood. Complains of chills. Has intermittent chest pain when he breathes deeply. Pain 0/10 at present. Appears restless but can speak in full sentences. No known drug allergies.
Vital Signs Blood pressure = 100/65
RR = 28
Pulse = 110bpm
Temp= 100.8 degrees FahrenheitNeurologic Awake alert and oriented x 3. Cardio-respiratory HR regular rhythm, rales and rhonchi heard on auscultation, productive cough. Oxygen saturation 90% on room air. Gastrointestinal Abdomen soft, nontender. Denies nausea, vomiting, diarrhea, constipation Extremities Warm to touch, no edema Social Assessment Smokes 1 pack a week. Denies alcohol use. Lives independently at home. >For each client finding, click to indicate if the finding is consistent with asthma, pneumonia, or pulmonary embolism. Each finding may support more than one type of respiratory condition. Select the answer below.
CorrectIncorrect -
Question 3 of 6
3. Question
Case Study Question 3 of 6
The emergency room nurse is admitting a 55-year-old male who presents with dyspnea, chest pain, and a cough.
Nurse Notes:
Notes Time 1000. Client reports symptoms started almost a week ago, and he was diagnosed with an upper respiratory infection by his primary care physician. Reports worsening dyspnea since yesterday. Has a productive cough sometimes tinged with blood. Complains of chills. Has intermittent chest pain when he breathes deeply. Pain 0/10 at present. Appears restless but can speak in full sentences. No known drug allergies.
Vital Signs Blood pressure = 100/65
RR = 28
Pulse = 110bpm
Temp= 100.8 degrees FahrenheitNeurologic Awake alert and oriented x 3. Cardio-respiratory HR regular rhythm, rales and rhonchi heard on auscultation, productive cough. Oxygen saturation 90% on room air. Gastrointestinal Abdomen soft, nontender. Denies nausea, vomiting, diarrhea, constipation Extremities Warm to touch, no edema Social Assessment Smokes 1 pack a week. Denies alcohol use. Lives independently at home. Chest X-Ray:
Notes Reveals pulmonary infiltrates bilaterally. Consolidation left lower lobe. No hilar lymphadenopathy. Laboratory Report:
Lab Results Reference range Hematocrit 45% Males: 42-52%
Females: 35-47%Hemoglobin 14 g/dL Males: 13-18 g/dL
Females:12-16 g/dLWBC 13,000 cell/mm3 4.5 – 10.5 x 103 cells/mm3 Potassium(serum) 4.5 mEq/L 3.5 to 5 mEq/L Sodium (serum) 137 mEq/L 135 to 145 mEq/L The chest x-ray report has been sent from radiology and labs are ready.
>Complete the sentence from the list of options below.
The nurse should recognize that the client is most likely experiencing (choose a, b, or c). As evidence by (choose d, e, f, or g) and (choose d, e, f, or g).
CorrectIncorrect -
Question 4 of 6
4. Question
Case Study Question 4 of 6
The emergency room nurse is admitting a 55-year-old male who presents with dyspnea, chest pain, and a cough.
Nurse Notes:
Notes Time 1000. Client reports symptoms started almost a week ago, and he was diagnosed with an upper respiratory infection by his primary care physician. Reports worsening dyspnea since yesterday. Has a productive cough sometimes tinged with blood. Complains of chills. Has intermittent chest pain when he breathes deeply. Pain 0/10 at present. Appears restless but can speak in full sentences. No known drug allergies.
Vital Signs Blood pressure = 100/65
RR = 28
Pulse = 110bpm
Temp= 100.8 degrees FahrenheitNeurologic Awake alert and oriented x 3. Cardio-respiratory HR regular rhythm, rales and rhonchi heard on auscultation, productive cough. Oxygen saturation 90% on room air. Gastrointestinal Abdomen soft, nontender. Denies nausea, vomiting, diarrhea, constipation Extremities Warm to touch, no edema Social Assessment Smokes 1 pack a week. Denies alcohol use. Lives independently at home. Chest X-Ray:
Notes Reveals pulmonary infiltrates bilaterally. Consolidation left lower lobe. No hilar lymphadenopathy. Laboratory Report:
Lab Results Reference range Hematocrit 45% Males: 42-52%
Females: 35-47%Hemoglobin 14 g/dL Males: 13-18 g/dL
Females:12-16 g/dLWBC 13,000 cell/mm3 4.5 – 10.5 x 103 cells/mm3 Potassium(serum) 4.5 mEq/L 3.5 to 5 mEq/L Sodium (serum) 137 mEq/L 135 to 145 mEq/L The chest x-ray report has been sent from radiology and labs are ready.
>Select the orders from each of the categories the nurse should include in the plan of care at this time. Each category may have more than one order.
Categories Orders Nursing a. Prepare to place client on airborne precautions b. Place client in a semi-fowlers position c. Encourage use of incentive spirometer d. Encourage PO fluids every 1-2 hours Medications e. Ceftriaxone 1gram IV q 24 hours and Azithromycin 500mg IV q 24 hours f. Tylenol 650mg PO q 4 hours PRN temperature greater than 101 g. Dextromethorphan 20mg ever 4 hours CorrectIncorrect -
Question 5 of 6
5. Question
Case Study Question 5 of 6
The emergency room nurse is admitting a 55-year-old male who presents with dyspnea, chest pain, and a cough.
Nurse Notes:
Notes Time 1000. Client reports symptoms started almost a week ago, and he was diagnosed with an upper respiratory infection by his primary care physician. Reports worsening dyspnea since yesterday. Has a productive cough sometimes tinged with blood. Complains of chills. Has intermittent chest pain when he breathes deeply. Pain 0/10 at present. Appears restless but can speak in full sentences. No known drug allergies.
Vital Signs Blood pressure = 100/65
RR = 28
Pulse = 110bpm
Temp= 100.8 degrees FahrenheitNeurologic Awake alert and oriented x 3. Cardio-respiratory HR regular rhythm, rales and rhonchi heard on auscultation, productive cough. Oxygen saturation 90% on room air. Gastrointestinal Abdomen soft, nontender. Denies nausea, vomiting, diarrhea, constipation Extremities Warm to touch, no edema Social Assessment Smokes 1 pack a week. Denies alcohol use. Lives independently at home. Chest X-Ray:
Notes Reveals pulmonary infiltrates bilaterally. Consolidation left lower lobe. No hilar lymphadenopathy. Most Recent Laboratory Report:
Lab Results Reference range Hematocrit 42% Males: 42-52%
Females: 35-47%Hemoglobin 13 g/dL Males: 13-18 g/dL
Females:12-16 g/dLWBC 9,000 cell/mm3 4.5 – 10.5 x 103 cells/mm3 Potassium(serum) 4.5 mEq/L 3.5 to 5 mEq/L Sodium (serum) 139 mEq/L 135 to 145 mEq/L >Five days later, the nurse is assessing the client and reviewing labs. Select the word choices that complete the sentence (order does not matter).
CorrectIncorrect -
Question 6 of 6
6. Question
Case Study Question 6 of 6
The emergency room nurse is admitting a 55-year-old male who presents with dyspnea, chest pain, and a cough.
Nurse Notes:
Notes Time 1000. Client reports symptoms started almost a week ago, and he was diagnosed with an upper respiratory infection by his primary care physician. Reports worsening dyspnea since yesterday. Has a productive cough sometimes tinged with blood. Complains of chills. Has intermittent chest pain when he breathes deeply. Pain 0/10 at present. Appears restless but can speak in full sentences. No known drug allergies.
Vital Signs Blood pressure = 100/65
RR = 28
Pulse = 110bpm
Temp= 100.8 degrees FahrenheitNeurologic Awake alert and oriented x 3. Cardio-respiratory HR regular rhythm, rales and rhonchi heard on auscultation, productive cough. Oxygen saturation 90% on room air. Gastrointestinal Abdomen soft, nontender. Denies nausea, vomiting, diarrhea, constipation Extremities Warm to touch, no edema Social Assessment Smokes 1 pack a week. Denies alcohol use. Lives independently at home. Chest X-Ray:
Notes Reveals pulmonary infiltrates bilaterally. Consolidation left lower lobe. No hilar lymphadenopathy. Most Recent Laboratory Report:
Lab Results Reference range Hematocrit 42% Males: 42-52%
Females: 35-47%Hemoglobin 13 g/dL Males: 13-18 g/dL
Females:12-16 g/dLWBC 9,000 cell/mm3 4.5 – 10.5 x 103 cells/mm3 Potassium(serum) 4.5 mEq/L 3.5 to 5 mEq/L Sodium (serum) 139 mEq/L 135 to 145 mEq/L >The nurse is performing discharge teaching. Which of the following statements indicates that teaching has been successful? Select all that apply.
CorrectIncorrect