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CAPSTONE FUNDAMENTALS QUESTIONS
BANK NEWEST 2024 ACTUAL EXAM 250
QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+ ||BRAND NEW
VERSION!
A nurse is admitting a client who has tuberculosis and a productive cough. Which of the following types of isolation precautions should the nurse initiate for the client?
- Contact
- Droplet
- Protective
- Airborne - ANSWER- D. Airborne
Rationale: The nurse should initiate airborne precautions
when a client has an infection that spreads through small droplets that remain airborne for longer periods, such as tuberculosis and measles. The client requires a negative- pressure airflow room, and staff should wear an N95 respirator when in contact with the client. The nurse should initiate contact precautions when a client has an infection 1 / 4
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that spreads through indirect contact, such as major wound infections or infection with multi-drug resistant organisms such as MRSA. The nurse should initiate droplet precautions when a client has an infection that spreads through droplets larger than 5 microns, such as pneumonia or streptococcal pharyngitis. The nurse should initiate a protective environment when clients require a room with positive-pressure airflow, such as those who have undergone stem-cell transplants.
A nurse is assessing a client who has Parkinson's disease. Which of the following manifestations should the nurse expect?
- Pruritus
- Hypertension
- Bradykinesia
- Xerostomia - ANSWER- C. Bradykinesia
Rationale: The nurse should expect to find bradykinesia or
difficulty moving in a client who has Parkinson's disease.The nurse should expect to find oily skin, which results from autonomic dysfunction, rather than pruritus, which results from dry skin. The nurse should expect to find orthostatic hypotension, which results from autonomic dysfunction. Te nurse should expect to find uncontrolled drooling, especially at night, instead of xerostomia or dry mouth in a client who has Parkinson's disease.
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A nurse is caring for a client with celiac disease. Which food should be removed from the meal tray?
- Corn bread
- Mashed potato
- Lentils
- Tortillas - ANSWER- D. Tortillas
Rationale: Tortillas contain gluten. Corn bread, mashed
potatoes and lentils do not contain gluten.
A nurse is assessing four clients for fluid balance. The nurse should identify that which of the following clients is exhibiting manifestations of dehydration?
- A client who has a urine specific gravity of 1.010.
- A client who has a weight gain of 2.2 kg (2 lb) in 24 hr.
- A client who has a hematocrit of 45%.
- A client who has a temperature of 39 degrees Celsius (102
degrees Fahrenheit). - ANSWER- D. A client who has a temperature of 39 degrees Celsius (102 degrees Fahrenheit).
Rationale: An elevated temperature is a manifestation of
dehydration. The urine specific gravity is within the expected reference range of 1.010 to 1.025. Concentrated urine and a specific gravity of grater than 1.030 are manifestations of dehydration. Weight gain is a manifestation of fluid volume excess. The hematocrit is 3 / 4
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within expected reference range of 37% to 64%. An elevated hematocrit is a manifestation of hemoconcentration and dehydration.
A nurse is caring for a client receiving radiation treatments for cancer. The client states he is experiencing dryness, redness and scaling at the treatment area. Which of the following should the nurse instruct the client to do?
- Sit in the sun for 15 minutes per day.
- Apply moist heat to the area twice daily.
- Liberally apply prescribed lotion to the area.
- Wash the affected area daily with antimicrobial soap. -
ANSWER- C. Liberally apply prescribed lotion to the area.
Rationale: Hydrating lotions are commonly prescribed to
treat irradiated areas. Antimicrobial soaps can be harsh and further traumatize new epidermal cells. The client should avoid applying other lotions not prescribed by the radiologist to affected areas. Clients receiving radiation therapy should avoid exposing irradiated areas to sun. Moist heat should be avoided over irradiated areas.
A nurse is caring for a client receiving opiates for pain management. Initially after the pain management plan was started, the client was sedated and sleeping most of the time.
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