1. A nurse is visiting a client who is Answer: C
receiving home health care,
focusing on medication and
dietary instructions and
management of heart failure. The
nurse should reinforce which
instruction?
A.) If you feel tired and short of
breath, lie down flat and prop up
your feet.
B.) Eating liver several times a
week will help build up your
strength.
C.) Your daily dose of furosemide
should be taken first thing in the
morning.
D.) The dose of enalapril will help
prevent vasodilation from
occurring.
2. A nurse planning care for a Answer: A
client who has undergone
transurethral resection of the
prostate (TURP) remembers that
the most common cause of
postoperative pain is which
factor?
A.) Bladder spasms
B.) Bleeding within the bladder
C.) The location of the incision
D.) Tension on the Foley catheter
,3. A nurse assessing the skin of a Answer: A
client who is immobile notes this
change in appearance of the skin
in the sacral area:
The nurse documents this finding
in which way?
A.) Stage I pressure ulcer
B.) Stage II pressure ulcer
C.) Stage III pressure ulcer
D.) Stage IV pressure ulcer
4. A nurse reinforces teaching Answer: D
given to a client with
gastroesophageal reflux disease
(GERD) about measures to
manage the disease. What does
the nurse encourage the client to
do to obtain relief of the
symptoms?
A.) Limit intake of coffee and tea.
B.) Eat three large, well-balanced
meals per day.
C.) Rest in a supine position for
30 minutes after each meal.
D.) Elevate the head of the bed at
least 6 to 8 inches for sleep.
, 5. A nurse provides instructions Answer: B
to a client who is taking
allopurinol for the treatment of
gout. Which statements by the
client indicate an understanding
of the medication?
A.) "I need to take the medication
1 hour before I eat."
B.) "I need to drink at least 8
glasses of fluid every day."
C. "I'll start taking a vitamin C
supplement each morning."
D.) "I can use an antihistamine
lotion if I get an itchy rash."
6. A client with phantom limb pain Answer: C
has decided to use
transcutaneous electrical nerve
stimulation (TENS) as prescribed
by the health care provider. The
nurse reinforces instructions
regarding the use of the TENS
unit. Which statements by the
client indicate a need for further
instruction regarding this pain-
relief measure?
A.) "I'm so glad this will help
relieve the pain."
B.) "Now I won't need to take so
many pain medications."
C.) "I need to put the electrodes
on the areas that you marked."
D.) "I'm not sure I'm going to like
having those electrodes attached
to my skin."
receiving home health care,
focusing on medication and
dietary instructions and
management of heart failure. The
nurse should reinforce which
instruction?
A.) If you feel tired and short of
breath, lie down flat and prop up
your feet.
B.) Eating liver several times a
week will help build up your
strength.
C.) Your daily dose of furosemide
should be taken first thing in the
morning.
D.) The dose of enalapril will help
prevent vasodilation from
occurring.
2. A nurse planning care for a Answer: A
client who has undergone
transurethral resection of the
prostate (TURP) remembers that
the most common cause of
postoperative pain is which
factor?
A.) Bladder spasms
B.) Bleeding within the bladder
C.) The location of the incision
D.) Tension on the Foley catheter
,3. A nurse assessing the skin of a Answer: A
client who is immobile notes this
change in appearance of the skin
in the sacral area:
The nurse documents this finding
in which way?
A.) Stage I pressure ulcer
B.) Stage II pressure ulcer
C.) Stage III pressure ulcer
D.) Stage IV pressure ulcer
4. A nurse reinforces teaching Answer: D
given to a client with
gastroesophageal reflux disease
(GERD) about measures to
manage the disease. What does
the nurse encourage the client to
do to obtain relief of the
symptoms?
A.) Limit intake of coffee and tea.
B.) Eat three large, well-balanced
meals per day.
C.) Rest in a supine position for
30 minutes after each meal.
D.) Elevate the head of the bed at
least 6 to 8 inches for sleep.
, 5. A nurse provides instructions Answer: B
to a client who is taking
allopurinol for the treatment of
gout. Which statements by the
client indicate an understanding
of the medication?
A.) "I need to take the medication
1 hour before I eat."
B.) "I need to drink at least 8
glasses of fluid every day."
C. "I'll start taking a vitamin C
supplement each morning."
D.) "I can use an antihistamine
lotion if I get an itchy rash."
6. A client with phantom limb pain Answer: C
has decided to use
transcutaneous electrical nerve
stimulation (TENS) as prescribed
by the health care provider. The
nurse reinforces instructions
regarding the use of the TENS
unit. Which statements by the
client indicate a need for further
instruction regarding this pain-
relief measure?
A.) "I'm so glad this will help
relieve the pain."
B.) "Now I won't need to take so
many pain medications."
C.) "I need to put the electrodes
on the areas that you marked."
D.) "I'm not sure I'm going to like
having those electrodes attached
to my skin."
