1
NUR 209 EXAM QUESTION BANK
LATEST VERSION
EXAM QUESTIONS AND ANSWERS /
NUR 209 (BRAND NEW VERSION)
A nurse designs a care plan to improve walking mobility in an older adult client.
When encouraged to implement the new strategies for ambulation the client
refuses to try and tells the nurse, "I find it easier to use a wheelchair." What
action by the nurse may have led to failure to meet the outcome? ANSWER-
D
developing the plan without client input
O
N
Which statement appropriately identifies an at-risk nursing diagnosis for a
O
woman 78 years of age who is confined to bed? ANSWER- Risk for
impaired skin integrity related to bed rest
T
C
O
A student takes an adult client's pulse and counts 20 beats/min. Knowing this is
PY
not the normal range for an adult pulse, what should the student do next?
ANSWER- Ask the instructor or a staff nurse to take the pulse.
A nurse takes the vital signs of a new hospital client admitted for severe
abdominal pain. Which initial step of the nursing process is this nurse
performing? ANSWER- Assessment
The RN is admitting a client to a medical unit. The nurse delegates the
measurement of the vital signs to unlicensed assistive personnel (UAP) while
she collects data. After completing the admission process the client reports a
severe headache, so the nurse reassesses the vital signs to find the client's blood
pressure extremely elevated. Whose responsibility is the accuracy of the blood
pressure measurement? ANSWER- the nurse
, 2
Nurses collect objective and subjective data when performing client
assessments. What is an example of objective data? ANSWER- The skin
of a client who has liver failure has a yellowish tint.
The nurse writes the following on the client's chart: The client will have
complete healing of the surgical incision on the right lower quadrant of the
abdomen in 3 weeks. This is a(an): ANSWER- outcome identification
The nurse is caring for a client who is suspected of having a kidney infection.
Which scenario involves the use of subjective data from the primary source?
ANSWER- The client tells the nurse that there is a burning sensation when
D
voiding.
O
N
A nurse is documenting assessment findings. Which finding would the nurse
O
include as objective data? Select all that apply. ANSWER- Blood pressure
T
128/68 mm Hg
C
Weight 175 lb (80 kg)
O
Bowel sounds active in all 4 quadrants
PY
A nurse is reviewing the health history and physical assessment findings for a
client who is having respiratory problems. Of the following data collected, what
data from the health history would be a cue to a nursing diagnosis for this
problem? ANSWER- "I get out of breath when I walk a few steps."
After completing an assessment of a client, which data would the nurse
determine is the priority for care? ANSWER- Severe bleeding from a
wound
, 3
The nurse is reviewing information about a client and notes the following
assessment data. Which data cue does the nurse recognize as subjective data?
ANSWER- Pain rating is 7
The nurse is completing rounds and notices the client has slumped down in bed.
The nurse assists the client to settle more comfortably, but the client grimaces
and tenses the body. The nurse does a complete pain assessment, checks the
time of last analgesic, and prepares the medication. Giving the medication is
which step of the nursing process? ANSWER- Implementation
A nurse administers medications to a client. What step of the nursing process
would the nurse perform next? ANSWER- Evaluating
D
O
A nurse is explaining the purpose of nursing diagnoses to a client. What would
N
be the most appropriate statement for the nurse to make? ANSWER- "Nursing
O
diagnoses are used to guide the nurse in selecting appropriate nursing
T
interventions."
C
O
A nurse is engaged in diagnostic reasoning to propose appropriate nursing
PY
diagnosis for a client. Place the steps in the order that they would occur from
first to last during this process. Correct response: Organizing the existence of
cues, Generating possible diagnoses, Comparing cues to possible diagnoses,
Conducting a focused data collection, Validating diagnoses
Which activity is the clearest example of the evaluation step in the nursing
process? ANSWER- Correct response: checking the client's blood pressure
30 minutes after administering captopril.
A nurse arrives at the home of an older adult client. The agency was called
because a neighbours noticed that the client was home alone. The nurse finds
the client alone in the living room. When asked about the client's daughter who
lives there and has been caring for her, the client says, "She went on vacation
, 4
for about a month. She'll be back soon." Further assessment reveals that there
are no other family members or services currently involved. The nurse would
identify this situation as: abandonment
During a home health care visit, the nurse identifies a nursing diagnosis of
Caregiver Role Strain for a parent who is caring for a child dependent on a
ventilator. What subjective assessment data would support the nurse's
diagnosis? ANSWER- The parent states, "I cannot allow anyone else to help
because they won't do it right."
The night shift RN is caring for a hospitalized adult client who reports being
unable to sleep. The client states, "I just can't sleep here. I miss my home. There
are too many lights and it is too hot." Which would be the best nursing
D
diagnosis for this client? ANSWER- Disturbed sleep pattern
O
N
The nurse is performing an admission assessment on a young client admitted
O
to the unit. Which of the following are considered objective data? Select all
T
that apply. ANSWER- 38-year-old man height 6' (1.82m) weight 195 lb
C
(89kg)
O
PY
A client has had major abdominal surgery and just returned to the unit from
the operating room. The nursing priority is to: ANSWER- complete
postoperative assessment.
During morning report, the night nurse tells the day nurse that the client refused
to allow the technician to draw blood for laboratory testing. What step would be
essential for the day nurse to complete before selecting a nursing diagnosis to
address this issue? ANSWER- The nurse should determine the reason for the
client's refusal.
When the nurse inspects a postoperative incision site for infection, which one of
the following types of assessments is being performed?
NUR 209 EXAM QUESTION BANK
LATEST VERSION
EXAM QUESTIONS AND ANSWERS /
NUR 209 (BRAND NEW VERSION)
A nurse designs a care plan to improve walking mobility in an older adult client.
When encouraged to implement the new strategies for ambulation the client
refuses to try and tells the nurse, "I find it easier to use a wheelchair." What
action by the nurse may have led to failure to meet the outcome? ANSWER-
D
developing the plan without client input
O
N
Which statement appropriately identifies an at-risk nursing diagnosis for a
O
woman 78 years of age who is confined to bed? ANSWER- Risk for
impaired skin integrity related to bed rest
T
C
O
A student takes an adult client's pulse and counts 20 beats/min. Knowing this is
PY
not the normal range for an adult pulse, what should the student do next?
ANSWER- Ask the instructor or a staff nurse to take the pulse.
A nurse takes the vital signs of a new hospital client admitted for severe
abdominal pain. Which initial step of the nursing process is this nurse
performing? ANSWER- Assessment
The RN is admitting a client to a medical unit. The nurse delegates the
measurement of the vital signs to unlicensed assistive personnel (UAP) while
she collects data. After completing the admission process the client reports a
severe headache, so the nurse reassesses the vital signs to find the client's blood
pressure extremely elevated. Whose responsibility is the accuracy of the blood
pressure measurement? ANSWER- the nurse
, 2
Nurses collect objective and subjective data when performing client
assessments. What is an example of objective data? ANSWER- The skin
of a client who has liver failure has a yellowish tint.
The nurse writes the following on the client's chart: The client will have
complete healing of the surgical incision on the right lower quadrant of the
abdomen in 3 weeks. This is a(an): ANSWER- outcome identification
The nurse is caring for a client who is suspected of having a kidney infection.
Which scenario involves the use of subjective data from the primary source?
ANSWER- The client tells the nurse that there is a burning sensation when
D
voiding.
O
N
A nurse is documenting assessment findings. Which finding would the nurse
O
include as objective data? Select all that apply. ANSWER- Blood pressure
T
128/68 mm Hg
C
Weight 175 lb (80 kg)
O
Bowel sounds active in all 4 quadrants
PY
A nurse is reviewing the health history and physical assessment findings for a
client who is having respiratory problems. Of the following data collected, what
data from the health history would be a cue to a nursing diagnosis for this
problem? ANSWER- "I get out of breath when I walk a few steps."
After completing an assessment of a client, which data would the nurse
determine is the priority for care? ANSWER- Severe bleeding from a
wound
, 3
The nurse is reviewing information about a client and notes the following
assessment data. Which data cue does the nurse recognize as subjective data?
ANSWER- Pain rating is 7
The nurse is completing rounds and notices the client has slumped down in bed.
The nurse assists the client to settle more comfortably, but the client grimaces
and tenses the body. The nurse does a complete pain assessment, checks the
time of last analgesic, and prepares the medication. Giving the medication is
which step of the nursing process? ANSWER- Implementation
A nurse administers medications to a client. What step of the nursing process
would the nurse perform next? ANSWER- Evaluating
D
O
A nurse is explaining the purpose of nursing diagnoses to a client. What would
N
be the most appropriate statement for the nurse to make? ANSWER- "Nursing
O
diagnoses are used to guide the nurse in selecting appropriate nursing
T
interventions."
C
O
A nurse is engaged in diagnostic reasoning to propose appropriate nursing
PY
diagnosis for a client. Place the steps in the order that they would occur from
first to last during this process. Correct response: Organizing the existence of
cues, Generating possible diagnoses, Comparing cues to possible diagnoses,
Conducting a focused data collection, Validating diagnoses
Which activity is the clearest example of the evaluation step in the nursing
process? ANSWER- Correct response: checking the client's blood pressure
30 minutes after administering captopril.
A nurse arrives at the home of an older adult client. The agency was called
because a neighbours noticed that the client was home alone. The nurse finds
the client alone in the living room. When asked about the client's daughter who
lives there and has been caring for her, the client says, "She went on vacation
, 4
for about a month. She'll be back soon." Further assessment reveals that there
are no other family members or services currently involved. The nurse would
identify this situation as: abandonment
During a home health care visit, the nurse identifies a nursing diagnosis of
Caregiver Role Strain for a parent who is caring for a child dependent on a
ventilator. What subjective assessment data would support the nurse's
diagnosis? ANSWER- The parent states, "I cannot allow anyone else to help
because they won't do it right."
The night shift RN is caring for a hospitalized adult client who reports being
unable to sleep. The client states, "I just can't sleep here. I miss my home. There
are too many lights and it is too hot." Which would be the best nursing
D
diagnosis for this client? ANSWER- Disturbed sleep pattern
O
N
The nurse is performing an admission assessment on a young client admitted
O
to the unit. Which of the following are considered objective data? Select all
T
that apply. ANSWER- 38-year-old man height 6' (1.82m) weight 195 lb
C
(89kg)
O
PY
A client has had major abdominal surgery and just returned to the unit from
the operating room. The nursing priority is to: ANSWER- complete
postoperative assessment.
During morning report, the night nurse tells the day nurse that the client refused
to allow the technician to draw blood for laboratory testing. What step would be
essential for the day nurse to complete before selecting a nursing diagnosis to
address this issue? ANSWER- The nurse should determine the reason for the
client's refusal.
When the nurse inspects a postoperative incision site for infection, which one of
the following types of assessments is being performed?
