Questions with Correct Answers
The nurse enters the client's room to administer medication. Which of the following
should the nurse do first?
A. Identify the client
B. Lower the bedrail
C. Provide for privacy
D. Wash his hands - ANSWERSCorrect answer: D
The nurse should wash his hands prior to touching the client or any of the client's
equipment
The nurse is assessing the dorsalis pedis pulses on an 88-year-old client. The nurse
notes the feet to be cool and assesses weak, thready pulses. What action should the
nurse take?
A. Assess the popliteal and femoral pulses
B. Assess a 1-minute apical pulse
C. Notify the physician STAT
D. Apply a warm pack and provider reassess in 20 minutes - ANSWERSCorrect
answer: A
Completing an assessment of other peripheral pulses will provide further data about the
adequacy of circulation to the legs.
The clinic nurse is reviewing the blood pressure readings from the client's home self-
monitoring device. The client states "Look, yesterday my blood pressure jumped up to
150/90 mm Hg. I should be taking more medicine." What is the nurse's best response?
A. "Yes, that is dangerously high. What were you doing?"
B. "Yes, I'm sure your provider will want to increase the dose."
C. "The doctor will first look at the pattern of your results."
D. "Don't worry. I'm sure it's just because you were stressed." - ANSWERSCorrect
answer: C
It is important for the nurse to complete client teaching about the necessity to look at
trends/patterns of the readings, rather than a one-time elevation.
Which of the following is a psychological response to pain?
, Anxiety
Increased blood pressure
Constricted pupils
Increased heart rate - ANSWERSAnswer: A
Anxiety is a psychological response to pain. Other psychological responses include
anger, depression, fear, and irritability
The nurse is assessing the confused client. How should the nurse assess the client's
pain?
A. Document that it is impossible to assess client's pain due to client's confusion
B. Observe the client carefully for changes in behavior or vital signs
C. Ask the client's family how much pain the client normally has
D. Use only pain scales that feature numbers or "faces" the client can point to -
ANSWERSCorrect answer: B
The nurse should observe the confused client for nonverbal cues to pain.
Mr. Baka's chronic cancer pain has recently increased, and he asks the home health
nurse what can be done. The patient is receiving long-acting morphine twice daily.
Which of the following is an appropriate response by the nurse?
A. "If you take more morphine, it will not change your pain relief."
B. "I'll call the physician and ask for an increased dose."
C. "The amount you are taking now is all I can give you."
D. "I'm worried if we increase your dose that you will stop breathing." -
ANSWERSCorrect answer: B
There is no ceiling on the analgesic effect of opioid narcotics. Patients develop a
tolerance to the effects, which often necessitates an increase in the dose.
What is an example of a secondary health prevention activity?
A. Chemotherapy IV infusion
B. Hepatitis B vaccine series
C. Gallbladder surgery
D. Flexible sigmoidoscopy at age 50 - ANSWERSCorrect answer: D
The American Cancer Society recommends that beginning at age 50, both men and
women at average risk for developing colorectal cancer should use one of several
screening exams. Health-screening activities are included in the definition of secondary
health prevention.
According to Leavell and Clark's work, blood pressure screening is an example of which
type of health care?
A. Primary prevention