COMPREHENSIVE REVIEW GUIDE 2026
◉ A nurse is caring for a client who reports itching 30 min after
receiving a newly prescribed medication. Which of the following
data should the nurse document in the client's medical record?
A. Client is itching from medication.
B. Client states, "I started to itch after taking that medication."
C. It appears that the client has a rash from the medication.
D. Rash from medication noted.. Answer: B. Client states, "I started to
itch after taking that medication."
The nurse should document information using an objective
description, putting the client's exact words in quotation marks.
◉ A nurse is planning care for a group of clients. The nurse should
expect to witness an informed consent for a client who will undergo
which of the following procedures?
A. Administration of an enema
B. Performance of a paracentesis
C. Insertion of an indwelling urinary catheter
D. Placement of an NG tube. Answer: B. Performance of a
paracentesis
, The nurse should expect to witness the informed consent for a client
prior to an invasive diagnostic procedure, such as a paracentesis.
◉ A nurse is caring for a client who is scheduled for surgery the
following day. During the night, the client is unable to sleep and is
restless. Which of the following statements should the nurse make?
A. "It must be difficult facing this type of surgery."
B. "Other clients who have had this surgery have done just fine."
C. "This facility is known for providing excellent care for people who
need this type of surgery."
D. "I can request a sleeping pill, if you think that will help.". Answer:
A. "It must be difficult facing this type of surgery."
Stating that it must be difficult to be in this position is an open-
ended and nonjudgmental statement that allows the client to talk
about their fears.
◉ A nurse is caring for a client who has limited mobility. Which of
the following actions should the nurse take to maintain the client's
skin integrity?
A. Use warm water when bathing the client.
B. Place a donut-shaped cushion in the client's chair.
C. Massage reddened areas over bony prominences.