1. A nurse is reinforcing teaching with a parent of a 4 month old infant during a
home visit. Which of the following statements by the parent indicates an
understanding of the teaching?
I will use the cool mist vaporizor in my baby's room
2. A nurse is reinforcing teaching with a client who has a new presciption for
verapamil. Which of the following instructions should the nurse include in
the teachings?
Change positions slowly
3. A nurse recieves change of shift report for a group of clients. Which of the
following clients should the nurse check first?
A client admitted to the facility who has ascending Guillain barrel syndrome
4. A nurse is caring for a client who has chlamydial infection and the new
prescription for doxycycline the client reports nausea and vomiting after
starting medication. Which of the following recommendations should the
nurse make?
Take the medications with crackers
5. A nurse is caring for a client who is postopperative following joint
replacement and has a new prescription for enoxaparin for which of the
following adverse effects should the nurse monitor?
Epistaxis
6. A nurse is collecting a health history from a parent of 4 year old child.
Which of the following statements to be is the priority for the nurse to
address?
,I have noticed that my child is withdrawn since we switched day care providers
7. A nurse is caring for a client who has heart failure and is taking furosemide.
Which of the following findings should the nurse recognize as an adverse
effect of this medication?
Hypokalemia
8. A nurse is reinforcing teaching about home safety with a parent of a 12
month old infant. Which of the following statements by the parent indicates
understanding of the teaching?
I will turn pot handles to the side of the stove while cooking
9. A nurse in an inpatient psychiatric unit is caring for a client who was raised
in an Asian culture which of the following communication techniques by the
nurse demonstrates cultural sensitivity?
Holding eye contact for brief instances
10.a nurse is checking for gastric residual volume(GRV) on a client who is
scheduled to receive an intermitted enteral feeding the nurse finds the client
to have a GRV greater than 250 ML on two consecutive measurements.
Which of the following actions should the nurse take?
Hold the feeding and recheck the GRV in 1 Hr
11.A nurse on a medical surgical unit is assigning tasks to assistive personnel
(AP) which of the following tasks should the nurse delegate to the AP?
Performing indwelling urinary catheter care
12.A nurse is caring for a client who has terminal cancer which of the following
actions should the nurse take to promote the clients autonomy?
,Allow client to choose treatment times
13.A nurse finds client's partner crying in the hallway the partner states I just
don't know how I am to go on after my husband is gone. Which of the
following responses should the nurse make?
Explain to me more about how you are feeling
14.a nurse is caring for an adolescent client who has bulimia nervosa. Which of
the following action should the nurse take?
Observe the client during and after meals
15.A nurse is checking a client who is postoperative and has a midline
abdominal incision. The nurse notes a separate of the incision. Which of the
following actions should the nurse take?
Place the client supine with the knee flexed
16.A nurse is caring for a school age child who has ADHD and is taking
methylphenidate. The nurse should identify which of the following is the
adverse effect of this medication?
Suppressed appetite
17.A nurse is administering medication to a client. Which of the following
actions should the nurse take?
Verify with another nurse when calculating a new dose of medication
, 18.A nurse is preparing to administer protamine to a client. Which of the
following therapeutic effects should the nurse expect to document in the
clients medical record?
Decreased clotting time
19.A nurse is caring for a client in a mental health facility who is pacing back
and fourth and wringing his hands. Which of the following actions should
the nurse take?
Walk with the client to the recreation room
20.A nurse is caring for a client who is 2 days postoperative following an above
the knew amputation. Which of the following actions should the nurse take
to promote progression toward independence and mobility for the client?
Encourage the client to use the over the bed trapeze
21.A nurse is at a pediatric clinic and is checking the vital signs of a 2 month
old infant prior to administrating immunizations. The nurse should recognize
that a respiratory rate of 30/min indicates which of the following findings?
The reference rate is within the expected reference range
22.A nurse in a clinic is collecting data from a client who had a vaginal birth 6
weeks ago. Which of the following findings should the nurse expect?
Report of lochia alba
23.A nurse is reinforcing discharged teaching with the family of a client who
has dependent personality disorder. Which of the following instructions
should the nurse include in the teachings?
Assume responsibility for making the clients decisions