Questions and Answers | Latest
Version | 2025/2026 | Correct & Verified
A nurse is preparing to assist a client to ambulate for the first time after surgery. What should the
nurse do first?
A. Put a gait belt on the client
✔✔B. Assess the client’s baseline vital signs
C. Ask the client to walk without support
D. Ensure the IV fluid is disconnected
A client on bed rest is at risk for skin breakdown. Which action should the nurse take to reduce
this risk?
A. Keep the client in one position
B. Apply lotion once a week
✔✔C. Reposition the client at least every 2 hours
D. Use a cold pack on pressure points
A nurse is teaching a client how to use an incentive spirometer. Which instruction is correct?
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,A. Blow into the device quickly
B. Take shallow breaths through the mouthpiece
✔✔C. Inhale slowly and deeply through the device
D. Hold breath for 1 second after inhalation
Which is the most accurate method for a nurse to verify a client’s identity before medication
administration?
A. Ask the client to state their room number
B. Ask the client to confirm their diagnosis
✔✔C. Ask the client to state their full name and date of birth
D. Check the client’s bed assignment
A nurse observes that a client’s IV site is red and swollen. What should the nurse do first?
A. Increase the IV flow rate
✔✔B. Stop the infusion
C. Apply heat immediately
D. Document the finding and continue
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,A nurse is reinforcing teaching about a low-sodium diet. Which food should the client avoid?
A. Fresh apple
B. Steamed rice
✔✔C. Canned soup
D. Fresh broccoli
When should a nurse perform hand hygiene?
A. After touching a clean dressing
✔✔B. Before and after patient contact
C. Only when hands are visibly dirty
D. Only after using the bathroom
A nurse is caring for a client who is experiencing shortness of breath. Which position is best?
A. Supine with head flat
✔✔B. High Fowler’s position
C. Trendelenburg position
D. Side-lying with head down
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, What is the best way to ensure a nasogastric tube is correctly placed before giving a feeding?
A. Check the length of tube exposed
B. Ask the client if it feels correct
✔✔C. Verify placement with pH testing of aspirate
D. Flush with water and listen for bubbling
A client with a fever is requesting a blanket. What should the nurse do?
A. Provide two blankets for comfort
✔✔B. Offer a light sheet instead
C. Give warm fluids immediately
D. Close all windows and vents
A nurse is documenting care provided to a client. Which statement follows legal guidelines for
documentation?
A. “Client was upset but will be fine soon”
✔✔B. “Client reported pain rated 8/10 in left leg”
C. “Client is lying in bed looking sad”
D. “Client seems to be pretending to have pain”
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