A A A A A
A Concept-Based Approach
A A A
4th Edition Volume III
A A A
by Pearson Education Chapters 1 - 16
A A A A A A
,TestABankAforAClinicalANursingASkills:AAAConcept-BasedAApproachA4thAEditionAPearsonA
,ClinicalANursingASkills:AAAConcept-
BasedAApproach,A4eA(Pearson)AEducationATestABankAChapterA1:AAssessment
1) AAclientAonAtheAmedical/surgicalAunitAcomplainsAofAsuddenAchestApains.AWhichAactionAwillAth
eAnurseAimplementAfirst?
A) CallAtheAhealthcareAprovider.
B) AdministerApainAmedication.
C) ReassessAaAnewAsetAofAvitalAsigns.
D) TurnAclientAfromAsupineAtoAlateral
.AANSWER:A C
Explanation:AA)ATheAnurseAwillAneedAtoAreassessAtheAclientAfirst,AbeforeAcallingAtheAhealthcar
eAprovider.
B) TheAnurseAwillAneedAtoAreassessAtheAclientAfirst,AbeforeAadministeringApainAmedication.
C) TheAnurseAneedsAtoAimplementAaAnewAsetAofAvitalAsignsAfirstAwhenAthereAisAaAchangeA
inAcondition.
D) TheAnurseAwillAneedAtoAreassessAtheAclientAfirst,AbeforeAmovingAtheAclient,AtoAavoidAmakingAt
heAchangeAinAclient'sAconditionAworse.
PageARef:A2
CognitiveALevel:A Applying
ClientANeed/Sub:A PhysiologicalAIntegrity:AReductionAofARiskAPotential
Standards:ANursingAProcess:AAssessmentA|ALearningAOutcome:A1.1A|AQSENACompetencies:A
Patient-CenteredACare
AACNADomainsAandAComps.:ADomainA2:APerson-
CenteredACareANLNACompetencies:A RelationshipACenteredACare
2) TheAnurseAisAobservingAtheAUAPAtakingAtheAtemperatureAofAanAunconsciousAclient.AWhichArou
teAwillAtheAnurseAquestionAtheAUAPAusing?
A) Oral
B) Rectal
C) Scanner
D) TympanicA
ANSWER:A A
Explanation:AA)ATheAtemperatureAofAanAunconsciousAclientAisAneverAtakenAbyAmouth.ATheArectal,A
tympanic,AorAscannerAmethodAisApreferred.
B) TheArectal,Atympanic,AorAscannerAmethodAisApreferred.
C) TheArectal,Atympanic,AorAscannerAmethodAisApreferred.
D) TheArectal,Atympanic,AorAscannerAmethodAisApreferre
d.APageARef:A24
CognitiveALevel:A Applying
ClientANeed/Sub:AAA SafeAandAEffectiveACareAEnvironment:ASafetyAandAInfectionAControlAStandard
s:A NursingAProcess:AEvaluationA|ALearningAOutcome:A1.1A|AQSENACompetencies:ASafetyAAACNADo
mainsAandAComps.:A DomainA5:AQualityAandASafety
NLNACompetencies:A QualityA&ASafety
1
, 3) TheAnurseAisAchangingAaA2-month-
oldAclient'sAdiaperAandAnotesAtheAclientAfeelsAwarmAtoAtouch.AWhichAmethodAshouldAtheAnurseA
useAtoAcheckAtheAbaby'sAtemperature?
A) Oral
B) Rectal
C) Axillary
D) TympanicAmembran
eAANSWER:A C
Explanation:A A)AOralAisAusedAforAageA3AorAolder.
B) TheArectalArouteAisAtheAleastAdesirable.
C) TheAaxillaryArouteAmayAnotAbeAasAaccurateAasAotherAroutesAforAdetectingAfeversAinAchildren.
D) TheAtympanicAmembraneAmayAbeAusedAforA3AmonthsAorAolde
r.APageARef:A29
CognitiveALevel:A Applying
ClientANeed/Sub:A PhysiologicalAIntegrity:AReductionAofARiskAPotential
Standards:A NursingAProcess:AEvaluatingA|ALearningAOutcome:A1.2A|AQSENACompetencies:ASafetyA
AACNADomainsAandAComps.:A DomainA5:AQualityAandASafety
NLNACompetencies:A QualityA&ASafety
4) AAclientAcomesAinAwithAexacerbationAofAchronicAobstructiveApulmonaryAdiseaseA(COPD).AWhichA
noninvasiveAdiagnosticAtestAwillAtheAnurseAimplementAtoAknowAthatAtheAclientAisAreceivingAenoug
hAoxygen?
A) ChestAx-ray
B) PulseAoximeter
C) ArterialAbloodAgasses
D) AssessmentAofArespiratoryArat
eAANSWER:A B
Explanation:A A)AAAchestAx-rayAisAnotAanAinterventionAaAnurseAcompletes.
B) AApulseAoximeterAprovidesAaAnoninvasiveAmethodAofAmeasuringAoxygenation,AorAoxygenAs
aturation,AinAtheAbloodAandAprovidesAaApulseAreading,AwhichAisAespeciallyAhelpfulAforAtheAclien
tAwithAaArespiratoryAillnessAorAdisease.
C) ArterialAbloodAgasesAareAanAinvasiveAdiagnosticAtest.
D) AssessingAaArespiratoryArateAisAimportantAforAtheAnurseAtoAimplement;Ahowever,AitAisAno
tAaAdiagnosticAtest.
PageARef:A21
CognitiveALevel:A Applying
ClientANeed/Sub:A PhysiologicalAIntegrity:AReductionAofARiskAPotential
Standards:ANursingAProcess:AImplementationA|ALearningAOutcome:A1.3A|AQSENACompetencies:AI
nformatics
AACNADomainsAandAComps.:A DomainA5:AQualityAandASafetyANLNAC
ompetencies:A QualityA&ASafety
2