Questions and Answers | Latest Version
| 2025/2026 | Correct & Verified
A nurse is performing an assessment on a client who is experiencing shortness of breath. Which
of the following should the nurse prioritize?
A. Check the client's oxygen saturation level
B. Assess for the presence of edema
C. ✔✔Auscultate the lungs for crackles or wheezes
D. Measure the client's blood pressure
A nurse is reinforcing teaching to a client about the importance of fluid intake. Which of the
following should the nurse include?
A. Drink fluids only when feeling thirsty
B. ✔✔Drink at least 8 glasses of water per day
C. Avoid fluids in the morning to prevent frequent urination
D. Limit fluids during meals
A nurse is assisting with the transfer of a client who is weak and unsteady. What should the
nurse do first?
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,A. ✔✔Assess the client's ability to bear weight
B. Encourage the client to push themselves up
C. Place the client in a wheelchair without assistance
D. Stand behind the client for support
A nurse is providing care to a client with a chest tube. Which of the following is the nurse's
priority action?
A. Encourage the client to cough and deep breathe
B. ✔✔Ensure that the chest tube is securely connected to the drainage system
C. Remove the chest tube dressing to inspect the site
D. Position the client flat to prevent discomfort
A nurse is caring for a client who has a wound with a dressing that is soiled. What is the nurse's
first action?
A. Apply a new dressing immediately
B. ✔✔Remove the soiled dressing and inspect the wound
C. Notify the physician about the dressing change
D. Clean the wound with antiseptic solution
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,A nurse is educating a client about using an incentive spirometer. Which of the following
instructions should the nurse include?
A. ✔✔Take a slow, deep breath in through the mouthpiece
B. Breathe out forcefully into the spirometer
C. Hold your breath for 5 seconds before exhaling
D. Use the spirometer only when feeling short of breath
A nurse is reviewing the care plan for a client receiving oxygen therapy. Which of the following
actions should the nurse take?
A. Ensure that oxygen is set to 5 L/min
B. ✔✔Check the tubing for kinks or obstructions
C. Remove the oxygen when the client is eating
D. Position the client in the supine position
A nurse is caring for a client with a history of falls. Which of the following is the most effective
intervention to prevent future falls?
A. ✔✔Implement a fall risk assessment and adjust the care plan accordingly
B. Restrict the client’s fluid intake to prevent accidents
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, C. Use restraints to prevent the client from moving
D. Keep the client’s environment dark and quiet
A nurse is preparing a client for a procedure. Which of the following actions is appropriate to
ensure informed consent is obtained?
A. ✔✔Verify that the client understands the procedure and its risks
B. Have the family sign the consent form
C. Allow the physician to explain the procedure
D. Provide the consent form after the procedure has begun
A nurse is caring for a client who is receiving parenteral nutrition. Which of the following should
the nurse monitor most closely?
A. Electrolyte levels
B. ✔✔Blood glucose levels
C. Respiratory rate
D. Urine output
A nurse is assessing a client who is at risk for dehydration. Which of the following findings is
most concerning?
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