A 58-year-old client admitted for community-acquired pneumonia is on continuous telemetry. Rhythm: regular sinus at 68/min. PR interval measures 0.22 second and is constant; QRS 0.08 second. The client is awake, BP 126/74, denies dizziness or chest pain. Which nursing action is most appropriate?

A preceptor observes a new RN treating a stable patient with regular narrow-complex tachycardia at 185/min who remains alert and normotensive after unsuccessful vagal maneuvers. Which action shows correct medication administration?

A 29-year-old with known Crohn disease reports sudden worsening abdominal pain after 2 days of diarrhea. Vitals: T 39.1°C (102.4°F), HR 118, BP 96/58, RR 24. Exam shows abdominal guarding with diffuse tenderness, worst in the right lower quadrant; bowel sounds are hypoactive, and the patient has rebound pain when the examiner releases pressure. Which finding pattern is most concerning and requires immediate intervention?

A 58-year-old with newly diagnosed acute myeloid leukemia started induction chemotherapy 7 days ago. The client reports fatigue and mild mouth soreness. Vitals: T 37.2°C (99.0°F), HR 104, BP 110/68, RR 18, SpO₂ 98% on room air. Current meds: ondansetron as needed, allopurinol. Which laboratory testing should the nurse prioritize to detect the most serious complication at this phase of therapy?  

A patient with a history of ulcerative colitis presents with worsening abdominal pain and fatigue. Which assessment finding is most characteristic of an acute ulcerative colitis flare?

An adult with prolonged QT history suddenly becomes unresponsive. The monitor shows a rapid polymorphic wide-complex tachycardia with “twisting” QRS axes. No pulse is palpable. Which action should the nurse take first?  

A 32-year-old patient presents with painless oral ulcers, photosensitive rash, and morning stiffness in the hands. Urinalysis shows trace protein. The clinician wants one laboratory test to screen for suspected systemic lupus erythematosus before ordering more specific assays. Which test should be ordered first?  

A patient with decompensated cirrhosis missed several doses of lactulose and is now more forgetful. Which assessment findings are most consistent with hepatic encephalopathy? Select all that apply.

You and the Rapid Response team are dispatched to four units at once. Who do you see first?  

A 56-year-old with known cirrhosis is admitted with jaundice, tense ascites, and confusion. Labs show elevated bilirubin and ammonia. Which assessment or lab findings are consistent with hepatic encephalopathy and decompensated liver disease? Select all that apply.