NURS 3632 EXAM 1 - PRACTICE
QUESTIONS
Nurse6enters6the6room6of6a6female6client6and6ask6how6she6is6doing,6client6states6"I'm6a6lit
tle6nervous6this6morning".6What6would6be6the6nurses6best6reply?6-6ans-
✔✔"Can6you6tell6me6more6about6how6you6are6feeling?"
A6nurse6observes6a6client6pacing6the6halls,6and6it6appears6as6if6the6client6has6been6cryin
g.6What6is6the6appropriate6action?6-6ans-✔✔Validate6perceptions6with6the6client
The6nurse6is6assessing6the6client6who6has6an6onset6of6severe6back6pain6of6an6unknown6
origin.6Which6would6the6nurse6ask6to6encourage6discussion?6-6ans-
✔✔What6do6you6think6caused6the6onset6of6your6back6pain?
In6which6of6the6following6situations6would6the6nurse6be6more6justified6in6implementing6tri
al-and-error6problem6solving?6-6ans-
✔✔The6nurse6is6attempting6to6landmark6an6obese6clients6apical6pulse
A6client6comes6to6the6ED6complaining6of6severe6chest6pain.6The6nurse6ask6the6client6que
stions6and6takes6VS.6Which6step6in6the6nursing6process6is6this?6-6ans-✔✔Assesing
A6nurse6is6examining6a6child626years6old.6Asked6on6her6findings,6she6initiates6a6care6plan
6for6a6potential6problem6with6normal6growth6and6development.6Which6step6of6the6nursing6
process6identifies6actual6and6potential6problems?6-6ans-✔✔Diagnosing
Self6evaluation6is6a6method6that6nurses6use6to6promote6their6own6development6and6to6gr
ow6in6confidence6in6their6nursing6roles.6The6process6is6refereed6to6as6what?6-6ans-
✔✔Reflective6practice
Profuse6smoke6is6coming6out6of6the6heating6unit6in6a6patient's6room.6What6should
the6nurse6do6first?6-6ans-✔✔Move6the6patient6out6of6the6room
The6nurse6is6providing6instructions6to6the6unlicensed6assistive6personnel6(UAP)6who6will6
be6caring6for6a6client6with6hand6restraints.6The6nurse6asks6the6UAP6to6repeat6the6instructi
ons6to6ensure6that6the6UAP6understands6the6care.6Which6statement,6if6made6by6the6UAP
,6indicated6an6understanding6of6the6care6for6this6client?6-6ans-
, ✔✔"I6need6to6remove6the6restraints6at6least6every626hours6to6perform6range-of-
motion6exercises"
Client6is6hospitalized6for6the6first6time.6Which6of6the6following6actions6would6the6nurse6tak
e6to6ensure6the6safety6of6the6client?6-6ans-✔✔Keep6unnecessary6furniture6out6of6the6way
After6correctly6positioning6a6client6for6a6urinary6catheterization6procedure,6the6nurse6sets6
up6a6sterile6field6and6places6the6kit6supplies6on6the6area.6The6nurse6hears6a6page6to6resp
ond6to6another6client6who6has6fallen6in6the6hallway.6Which6of6the6following6would6be6the6
most6appropriate6nursing6actions?6-6ans-
✔✔Ensure6the6clients6safety,6discard6the6sterile6equipment,6and6resound6to6the6other6cli
ent.
A6patient's6stool6specimen6is6positive6for6Clostridium6difficile.6Which6isolation6precaution
s6should6the6nurse6institute6for6this6patient?6-6ans-✔✔Contact
A6nurse6is6following6the6principles6of6medical6asepsis6when6performing6patient6care6in6a6
hospital6setting.6Which6nursing6action6performed6by6the6nurse6follows6these6recommend
ed6guidelines?6-6ans-
✔✔The6nurse6moves6the6patient6table6away6from6the6nurse's6body6when6wiping6it6off6aft
er6a6meal
The6nurse6has6opened6the6sterile6supplies6and6put6on6two6sterile6gloves6to6complete6a6st
erile6dressing6change,6a6procedure6that6requires6surgical6asepsis.6Which6action6by6the6n
urse6is6appropriate?6-6ans-
✔✔Consider6the6outer616in6of6the6sterile6field6as6contaminated.
The6nurse6caring6for6patients6in6a6hospital6setting6institutes6CDC6standard6precaution6re
commendations6for6which6category6of6patients?6-6ans-
✔✔All6patients6receiving6care6in6hospitals
A6nurse6must6make6an6unoccupied6bed.6Which6nursing6action6is6most6important?6-6ans-
✔✔Ensure6that6the6bottom6of6the6sheet6is6free6of6wrinkles
The6nurse6us6providing6hygiene6to6a6patient6with6peripheral6neuropathy.6The6nurse6shou
ld:6-6ans-✔✔Wash6the6feet6with6lukewarm6water6and6dry6well.
A6nurse6is6providing6for6the6hygiene6and6grooming6needs6for6an6obese6patient6who6easil
y6becomes6short6of6breath6when6moving6about.6Which6is6the6most6important6nursing6inte
rvention?6-6ans-✔✔Assessing6response6to6activity
A6client6who6is6unconscious6needs6frequent6mouth6care.6While6performing6mouth6care,6t
he6nurse6tale6care6to6place6the6client6in6which6of6the6following6positions?6-6ans-✔✔Side-
lying
QUESTIONS
Nurse6enters6the6room6of6a6female6client6and6ask6how6she6is6doing,6client6states6"I'm6a6lit
tle6nervous6this6morning".6What6would6be6the6nurses6best6reply?6-6ans-
✔✔"Can6you6tell6me6more6about6how6you6are6feeling?"
A6nurse6observes6a6client6pacing6the6halls,6and6it6appears6as6if6the6client6has6been6cryin
g.6What6is6the6appropriate6action?6-6ans-✔✔Validate6perceptions6with6the6client
The6nurse6is6assessing6the6client6who6has6an6onset6of6severe6back6pain6of6an6unknown6
origin.6Which6would6the6nurse6ask6to6encourage6discussion?6-6ans-
✔✔What6do6you6think6caused6the6onset6of6your6back6pain?
In6which6of6the6following6situations6would6the6nurse6be6more6justified6in6implementing6tri
al-and-error6problem6solving?6-6ans-
✔✔The6nurse6is6attempting6to6landmark6an6obese6clients6apical6pulse
A6client6comes6to6the6ED6complaining6of6severe6chest6pain.6The6nurse6ask6the6client6que
stions6and6takes6VS.6Which6step6in6the6nursing6process6is6this?6-6ans-✔✔Assesing
A6nurse6is6examining6a6child626years6old.6Asked6on6her6findings,6she6initiates6a6care6plan
6for6a6potential6problem6with6normal6growth6and6development.6Which6step6of6the6nursing6
process6identifies6actual6and6potential6problems?6-6ans-✔✔Diagnosing
Self6evaluation6is6a6method6that6nurses6use6to6promote6their6own6development6and6to6gr
ow6in6confidence6in6their6nursing6roles.6The6process6is6refereed6to6as6what?6-6ans-
✔✔Reflective6practice
Profuse6smoke6is6coming6out6of6the6heating6unit6in6a6patient's6room.6What6should
the6nurse6do6first?6-6ans-✔✔Move6the6patient6out6of6the6room
The6nurse6is6providing6instructions6to6the6unlicensed6assistive6personnel6(UAP)6who6will6
be6caring6for6a6client6with6hand6restraints.6The6nurse6asks6the6UAP6to6repeat6the6instructi
ons6to6ensure6that6the6UAP6understands6the6care.6Which6statement,6if6made6by6the6UAP
,6indicated6an6understanding6of6the6care6for6this6client?6-6ans-
, ✔✔"I6need6to6remove6the6restraints6at6least6every626hours6to6perform6range-of-
motion6exercises"
Client6is6hospitalized6for6the6first6time.6Which6of6the6following6actions6would6the6nurse6tak
e6to6ensure6the6safety6of6the6client?6-6ans-✔✔Keep6unnecessary6furniture6out6of6the6way
After6correctly6positioning6a6client6for6a6urinary6catheterization6procedure,6the6nurse6sets6
up6a6sterile6field6and6places6the6kit6supplies6on6the6area.6The6nurse6hears6a6page6to6resp
ond6to6another6client6who6has6fallen6in6the6hallway.6Which6of6the6following6would6be6the6
most6appropriate6nursing6actions?6-6ans-
✔✔Ensure6the6clients6safety,6discard6the6sterile6equipment,6and6resound6to6the6other6cli
ent.
A6patient's6stool6specimen6is6positive6for6Clostridium6difficile.6Which6isolation6precaution
s6should6the6nurse6institute6for6this6patient?6-6ans-✔✔Contact
A6nurse6is6following6the6principles6of6medical6asepsis6when6performing6patient6care6in6a6
hospital6setting.6Which6nursing6action6performed6by6the6nurse6follows6these6recommend
ed6guidelines?6-6ans-
✔✔The6nurse6moves6the6patient6table6away6from6the6nurse's6body6when6wiping6it6off6aft
er6a6meal
The6nurse6has6opened6the6sterile6supplies6and6put6on6two6sterile6gloves6to6complete6a6st
erile6dressing6change,6a6procedure6that6requires6surgical6asepsis.6Which6action6by6the6n
urse6is6appropriate?6-6ans-
✔✔Consider6the6outer616in6of6the6sterile6field6as6contaminated.
The6nurse6caring6for6patients6in6a6hospital6setting6institutes6CDC6standard6precaution6re
commendations6for6which6category6of6patients?6-6ans-
✔✔All6patients6receiving6care6in6hospitals
A6nurse6must6make6an6unoccupied6bed.6Which6nursing6action6is6most6important?6-6ans-
✔✔Ensure6that6the6bottom6of6the6sheet6is6free6of6wrinkles
The6nurse6us6providing6hygiene6to6a6patient6with6peripheral6neuropathy.6The6nurse6shou
ld:6-6ans-✔✔Wash6the6feet6with6lukewarm6water6and6dry6well.
A6nurse6is6providing6for6the6hygiene6and6grooming6needs6for6an6obese6patient6who6easil
y6becomes6short6of6breath6when6moving6about.6Which6is6the6most6important6nursing6inte
rvention?6-6ans-✔✔Assessing6response6to6activity
A6client6who6is6unconscious6needs6frequent6mouth6care.6While6performing6mouth6care,6t
he6nurse6tale6care6to6place6the6client6in6which6of6the6following6positions?6-6ans-✔✔Side-
lying
