7/8/26, 12:59 PM NSG 3100 Exam 2, || QUESTIONS WITH ACCURATE ANSWERS || comprehensive questions and verified answers | GET IT RIGH…
NSG 3100 Exam 2, || QUESTIONS WITH
ACCURATE ANSWERS || comprehensive
questions and verified answers | GET IT RIGHT
|2026!
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Terms in this set (30)
The client's temperature at 8:00 am Answer: 2. Rationale: Although the temperature is
using an oral electronic thermometer slightly lower than expected for the morning, it
is 36.1°C (97.2°F). If the respiration, would be best to determine the client's previous
pulse, and blood pressure were temperature range next. This may be a normal
within normal range, what would the range for this client. Depending on that finding, the
nurse do next? nurse might want to retake it in a few minutes—no
1. Wait 15 minutes and retake it. need to wait 15 minutes (option 3) or with another
2. Check what the client's thermometer to see if the initial thermometer was
temperature was the last time it was functioning properly. Chart after determining that
taken. the temperature has been measured properly
3. Retake it using a different (option 4). Cognitive Level: Applying. Client Need:
thermometer. Health Maintenance and Promotion. Nursing
4. Chart the temperature; it is normal Process: Assessment. Learning Outcome: 29-4.
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Which client meets the criteria for Answer: 3. Rationale: The apical rate would confirm
selection of the apical site for the rate and determine the actual cardiac rhythm
assessment of the pulse rather than a for a client with an abnormal rhythm; a radial pulse
radial pulse? would only reveal the heart rate and suggest an
1. A client who is in shock arrhythmia. For clients in shock, use the carotid or
2. A client whose pulse changes with femoral pulse (option 1). The radial pulse is
body position changes adequate for determining a change in the
3. A client with an arrhythmia orthostatic heart rate (option 2). The radial pulse is
4. A client who had surgery less than appropriate for routine postoperative vital sign
24 hours ago checks for clients with regular pulses (option 4).
Cognitive Level: Understanding. Client Need:
Health Promotion and Maintenance. Nursing
Process: Planning. Learning Outcome: 29-5
When the nurse enters a client's Answer: 4. Rationale: Since the client's needs are
room to measure routine vital signs, always considered first, the measurement should
the client is on the phone. What be delayed unless the client is in distress or there
technique should the nurse use to are other urgent reasons. Option 1: Respirations
determine the respiratory rate? should be measured for 30 seconds to 1 minute
1. Count the respirations during and are affected by talking. Option 2: There needs
conversational pauses. to be an important reason for interrupting the
2. Ask the client to end the phone client. Option 3: It is inappropriate to wait and
call now and resume it at a later time. listen to the client's conversation. Cognitive Level:
3. Wait at the client's bedside until Understanding. Client Need: Health Promotion and
the phone call is completed and Maintenance. Nursing Process: Planning. Learning
then count respirations. Outcome: 29-3d.
4. Since there is no evidence of
distress or urgency, postpone the
measurement until later.
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For a client with a previous blood Answer: 2. Rationale: If the cuff is inflated to about
pressure of 138/74 mmHg and pulse 30 mmHg over previous systolic pressure, that
of 64 beats/min, approximately how would be 168. To ensure that the diastolic
long should the nurse take to release has been determined, the cuff should be released
the blood pressure cuff in order to slowly until the mid60s mmHg (and then
obtain an accurate reading? completely) for someone with a previous reading
1. 10-20 seconds of 74. The cuff should be deflated at a rate of 2 to 3
2. 30-45 seconds mm per second. Thus, a range of 90 mmHg will
3. 1-1.5 minutes require 30 to 45 seconds. Cognitive Level:
4. 3-3.5 minutes Analyzing. Client Need: Health Promotion and
Maintenance. Nursing Process: Implementation.
Learning Outcome: 29-3e
It would be appropriate to delegate Answer: 1. Rationale: Vital signs measurement may
the taking of vital signs of which be delegated to UAP if the client is in stable
client to unlicensed assistive condition, the findings are expected to be
personnel? predictable, and the technique requires no
1. A client being prepared for modification. Only the preoperative client meets
elective facial surgery with a history these requirements. In addition, UAP are not
of stable hypertension delegated to take apical pulse measurements for
2. A client receiving a blood the client with an irregular pulse as would be the
transfusion with a history of case with the client newly started on antiarrhythmic
transfusion reactions medication (option 3). Cognitive Level: Applying.
3. A client recently started on a new Client Need: Health Promotion and Maintenance.
antiarrhythmic agent Nursing Process: Planning. Learning Outcome: 29-
4. A client who is admitted frequently 8.
with asthma attacks
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NSG 3100 Exam 2, || QUESTIONS WITH
ACCURATE ANSWERS || comprehensive
questions and verified answers | GET IT RIGHT
|2026!
Save Add to calendar
Terms in this set (30)
The client's temperature at 8:00 am Answer: 2. Rationale: Although the temperature is
using an oral electronic thermometer slightly lower than expected for the morning, it
is 36.1°C (97.2°F). If the respiration, would be best to determine the client's previous
pulse, and blood pressure were temperature range next. This may be a normal
within normal range, what would the range for this client. Depending on that finding, the
nurse do next? nurse might want to retake it in a few minutes—no
1. Wait 15 minutes and retake it. need to wait 15 minutes (option 3) or with another
2. Check what the client's thermometer to see if the initial thermometer was
temperature was the last time it was functioning properly. Chart after determining that
taken. the temperature has been measured properly
3. Retake it using a different (option 4). Cognitive Level: Applying. Client Need:
thermometer. Health Maintenance and Promotion. Nursing
4. Chart the temperature; it is normal Process: Assessment. Learning Outcome: 29-4.
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Which client meets the criteria for Answer: 3. Rationale: The apical rate would confirm
selection of the apical site for the rate and determine the actual cardiac rhythm
assessment of the pulse rather than a for a client with an abnormal rhythm; a radial pulse
radial pulse? would only reveal the heart rate and suggest an
1. A client who is in shock arrhythmia. For clients in shock, use the carotid or
2. A client whose pulse changes with femoral pulse (option 1). The radial pulse is
body position changes adequate for determining a change in the
3. A client with an arrhythmia orthostatic heart rate (option 2). The radial pulse is
4. A client who had surgery less than appropriate for routine postoperative vital sign
24 hours ago checks for clients with regular pulses (option 4).
Cognitive Level: Understanding. Client Need:
Health Promotion and Maintenance. Nursing
Process: Planning. Learning Outcome: 29-5
When the nurse enters a client's Answer: 4. Rationale: Since the client's needs are
room to measure routine vital signs, always considered first, the measurement should
the client is on the phone. What be delayed unless the client is in distress or there
technique should the nurse use to are other urgent reasons. Option 1: Respirations
determine the respiratory rate? should be measured for 30 seconds to 1 minute
1. Count the respirations during and are affected by talking. Option 2: There needs
conversational pauses. to be an important reason for interrupting the
2. Ask the client to end the phone client. Option 3: It is inappropriate to wait and
call now and resume it at a later time. listen to the client's conversation. Cognitive Level:
3. Wait at the client's bedside until Understanding. Client Need: Health Promotion and
the phone call is completed and Maintenance. Nursing Process: Planning. Learning
then count respirations. Outcome: 29-3d.
4. Since there is no evidence of
distress or urgency, postpone the
measurement until later.
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For a client with a previous blood Answer: 2. Rationale: If the cuff is inflated to about
pressure of 138/74 mmHg and pulse 30 mmHg over previous systolic pressure, that
of 64 beats/min, approximately how would be 168. To ensure that the diastolic
long should the nurse take to release has been determined, the cuff should be released
the blood pressure cuff in order to slowly until the mid60s mmHg (and then
obtain an accurate reading? completely) for someone with a previous reading
1. 10-20 seconds of 74. The cuff should be deflated at a rate of 2 to 3
2. 30-45 seconds mm per second. Thus, a range of 90 mmHg will
3. 1-1.5 minutes require 30 to 45 seconds. Cognitive Level:
4. 3-3.5 minutes Analyzing. Client Need: Health Promotion and
Maintenance. Nursing Process: Implementation.
Learning Outcome: 29-3e
It would be appropriate to delegate Answer: 1. Rationale: Vital signs measurement may
the taking of vital signs of which be delegated to UAP if the client is in stable
client to unlicensed assistive condition, the findings are expected to be
personnel? predictable, and the technique requires no
1. A client being prepared for modification. Only the preoperative client meets
elective facial surgery with a history these requirements. In addition, UAP are not
of stable hypertension delegated to take apical pulse measurements for
2. A client receiving a blood the client with an irregular pulse as would be the
transfusion with a history of case with the client newly started on antiarrhythmic
transfusion reactions medication (option 3). Cognitive Level: Applying.
3. A client recently started on a new Client Need: Health Promotion and Maintenance.
antiarrhythmic agent Nursing Process: Planning. Learning Outcome: 29-
4. A client who is admitted frequently 8.
with asthma attacks
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