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,When caring for a child, a nurse plans to use nonpharmacological interventions to enhance the
effectiveness of pain medication. Which of the following strategies incorporates visualization techniques
to help decrease the child's discomfort? - correct ans:Blowing bubbles with liquid soap to "blow the hurt
away"
A nurse is providing education to a client who expresses a desire to lose weight. Which of the following
recommendations should the nurse make? - correct ans:"Follow the MyPlate plan."
A nurse is assigning task roles for a group of clients in a community mental health clinic. Which of the
following tasks should the nurse assign to the member of the group functioning as the orienter? -
correct ans:Noting the progress of the group toward assigned goals
A nurse is caring for a client who has a leg cast and is returning a demonstration on the proper use of
crutches while climbing stairs. Identify the sequence the client should follow. (Move the steps into the
box on the right, placing them in the order of performance. Use all the steps.) - correct ans:Stand in the
tripod position.
Place body weight on the crutches
Place the unaffected leg on the stair.
Move the affected leg and the crutches up to the stair.
A nurse is assessing for correct placement of a client's NG feeding tube prior to administering a bolus
feeding. Which of the following actions should the nurse take? - correct ans:Aspirate contents from the
tube and verify the pH level.
A nurse is admitting a client to the mental health unit following a suicide attempt. The client states, "My
family does not care whether I live or die." Which of the following responses should the nurse make? -
correct ans:"How does this make you feel?"
A nurse is caring for a client who is immediately postoperative following a total vaginal hysterectomy.
Which of the following actions should the nurse take first? - correct ans:Measure the client's vital signs.
, A nurse is caring for a 4-year-old preschooler in an emergency department (ED).
After completing the assessment and reviewing the preschooler's medical record, which of the following
actions should the nurse plan to take? - correct ans:administer supplemental oxygen, place the
preschooler on the affected side, and administer an antipyretic.
A nurse is caring for a client who has fluid volume overload. Which of the following tasks should the
nurse delegate to an assistive personnel (AP)? - correct ans:Measure the client's daily weight.
A nurse is caring for a group of clients. Which of the following clients should the nurse attend to first? -
correct ans:A client who is anxious and attempting to pull out an IV line
A nurse is providing discharge teaching about the use of car seats to the guardian of a newborn. Which
of the following statements by one of the guardians indicates an understanding of the teaching? -
correct ans:"I should ensure that the harness is snug around my baby's body."
A nurse is reviewing the laboratory results of a toddler who has hemophilia A. Which of the following
aPTT (30 to 40 seconds) values should the nurse expect? - correct ans:45 seconds
A nurse manager is planning to make changes to the current scheduling system on the unit. To facilitate
the staff's acceptance of this change, which of the following actions should the nurse manager take first?
- correct ans:Provide information about scheduling issues to the staff.
A nurse is caring for a client admitted with profuse vomiting and abdominal pain.
The client is at risk for developing "blank" due to "blank" - correct ans:Peritonitis due to bowel
obstruction.
The client is one day postoperative following a thyroidectomy.
Select the 2 findings the nurse should report to the provider. - correct ans:Heart Rate
Dressing