N153: Fundamentals Quiz Final
A nurse is assessing a client who is postoperative following thoracic surgery. Which of the
following manifestations should alert the nurse to the possibility of early hypovolemic shock? -
Answer: Irritability
Which nursing action demonstrates safe principles of administering a routine immunization to
an infant? - Answer: Inject the vaccine into the vastus lateralis muscle.
A nurse is caring for a female client who has an indwelling urinary catheter. The nurse
determines that the assistive personnel (AP) performing hygiene care for the client requires
further education about the care of indwelling catheters when she observes the AP - Answer:
hanging the collection bag at the level of the bladder.
A nurse caring for a client who is immobilized knows that, without interventions to prevent
constipation and fecal impaction, this client is at risk for - Answer: intestinal obstruction.
A nurse has organized a discussion session for assistive personnel (AP) at an extended care
facility about cultural and religious traditions and rituals at the time of death. The nurse
determines that one of the participants has a misconception when the AP states that - Answer:
organ donation is strictly forbidden by the Baptist Church.
A nurse is caring for a client on strict bed rest. When entering the client's room, the nurse
notices flames in the waste basket. The nurse's priority action is to - Answer: pull the client out
into the hall in the bed.
While preparing a client for discharge, the nurse teaches the proper position for postural
drainage. The nurse knows that to achieve success in this teaching program, the information
about the client that is most important is the - Answer: client's goal concerning his ability to be
self-sufficient.
, N153: Fundamentals Quiz Final
A right handed client is admitted with a fractured right arm and contusions of the left wrist
following a motor vehicle crash. Which intervention should the nurse use when assisting the
client with feeding? - Answer: Offer small bites of food.
When transcribing the orders for a client admitted with an exacerbation of systemic lupus
erythematosus (SLE), a newly licensed nurse notes that the provider has prescribed a
medication with which the nurse is unfamiliar. The nurse should - Answer: consult the
medication reference book available on the unit.
A client is 2 days postoperative following an appendectomy. While changing the linens on the
client's bed, the nurse notes drainage from an infected wound has soiled the bed sheet. The
appropriate nursing action is to - Answer: carefully place the soiled sheet in a moisture-resistant
plastic laundry bag.
Following an accidental fall while playing volleyball, a client is sent home in a lower leg cast due
to a hairline fracture of the tibia and must use crutches. When teaching the client the four-point
gait, the nurse explains that the client should - Answer: be able to bear weight on both legs.
A client is prescribed a hypothermia blanket. When caring for the client, the nurse - Answer:
places a layer of cloth between the client and the blanket.
A client is ambulating in the hallway in bare feet. What is the priority nursing action at this
time? - Answer: Get the client's slippers and have him put them on.
A client is about to have a nasogastric tube (NG) inserted. The nurse explains the procedure and
is ready to begin the insertion when the client says, "No way! You are not putting that hose
down my throat. Get away from me." Which of the following statements is an appropriate
nursing response? - Answer: "I can see that this is upsetting you."
A nurse is assessing a client who is postoperative following thoracic surgery. Which of the
following manifestations should alert the nurse to the possibility of early hypovolemic shock? -
Answer: Irritability
Which nursing action demonstrates safe principles of administering a routine immunization to
an infant? - Answer: Inject the vaccine into the vastus lateralis muscle.
A nurse is caring for a female client who has an indwelling urinary catheter. The nurse
determines that the assistive personnel (AP) performing hygiene care for the client requires
further education about the care of indwelling catheters when she observes the AP - Answer:
hanging the collection bag at the level of the bladder.
A nurse caring for a client who is immobilized knows that, without interventions to prevent
constipation and fecal impaction, this client is at risk for - Answer: intestinal obstruction.
A nurse has organized a discussion session for assistive personnel (AP) at an extended care
facility about cultural and religious traditions and rituals at the time of death. The nurse
determines that one of the participants has a misconception when the AP states that - Answer:
organ donation is strictly forbidden by the Baptist Church.
A nurse is caring for a client on strict bed rest. When entering the client's room, the nurse
notices flames in the waste basket. The nurse's priority action is to - Answer: pull the client out
into the hall in the bed.
While preparing a client for discharge, the nurse teaches the proper position for postural
drainage. The nurse knows that to achieve success in this teaching program, the information
about the client that is most important is the - Answer: client's goal concerning his ability to be
self-sufficient.
, N153: Fundamentals Quiz Final
A right handed client is admitted with a fractured right arm and contusions of the left wrist
following a motor vehicle crash. Which intervention should the nurse use when assisting the
client with feeding? - Answer: Offer small bites of food.
When transcribing the orders for a client admitted with an exacerbation of systemic lupus
erythematosus (SLE), a newly licensed nurse notes that the provider has prescribed a
medication with which the nurse is unfamiliar. The nurse should - Answer: consult the
medication reference book available on the unit.
A client is 2 days postoperative following an appendectomy. While changing the linens on the
client's bed, the nurse notes drainage from an infected wound has soiled the bed sheet. The
appropriate nursing action is to - Answer: carefully place the soiled sheet in a moisture-resistant
plastic laundry bag.
Following an accidental fall while playing volleyball, a client is sent home in a lower leg cast due
to a hairline fracture of the tibia and must use crutches. When teaching the client the four-point
gait, the nurse explains that the client should - Answer: be able to bear weight on both legs.
A client is prescribed a hypothermia blanket. When caring for the client, the nurse - Answer:
places a layer of cloth between the client and the blanket.
A client is ambulating in the hallway in bare feet. What is the priority nursing action at this
time? - Answer: Get the client's slippers and have him put them on.
A client is about to have a nasogastric tube (NG) inserted. The nurse explains the procedure and
is ready to begin the insertion when the client says, "No way! You are not putting that hose
down my throat. Get away from me." Which of the following statements is an appropriate
nursing response? - Answer: "I can see that this is upsetting you."
