NR 547 CERTIFICATION STUDY GUIDE 2026
COMPLETE QUESTIONS WITH ANSWERS
▶ Before surgery, the nurse observes the client listening to music on the
radio. Based on this observation, the nurse may try which
nonpharmacologic intervention for pain relief in the postoperative setting?
A) Cutaneous skin stimulation
B) Imagery
C) Radiofrequency ablation
D) Hypnosis. Answer: B
Imagery is a form of distraction in which the client is encouraged to
visualize about some pleasant or desirable feeling, sensation, or event.
Behaviors that are helpful in assessing a client's capacity for imagery
include being able to listen to music or other auditory stimuli.
▶ What interrelated constructs facilitate a nurse to become culturally
competent?
A) Cultural desire, self-awareness, cultural knowledge, and cultural skill
B) Cultural desire, self-awareness, cultural knowledge, and cultural
diversity
C) Cultural desire, self-awareness, cultural knowledge, and cultural identity
D) Cultural diversity, self-awareness, cultural skill, and cultural knowledge.
Answer: A
The process of cultural competence consists of four interrelated constructs:
cultural desire, self-awareness, cultural knowledge, and cultural skill.
Cultural diversity in the context of health care refers to achieving the
highest level of health care for all people by addressing societal inequalities
and historical and contemporary injustices. Cultural identity is the norms,
values, beliefs, and behaviors of a culture learned through families and
group members.
▶ The emphasis on understanding cultural influence on health care is
important because of:
,A) disability entitlements.
B) HIPAA requirements.
C) litigious society.
D) increasing global diversity.. Answer: D
Culture is an essential aspect of health care because of increasing
diversity. Disability entitlements refer to defined benefits for eligible mental
or physically disabled beneficiaries in relation to housing, employment, and
health care. HIPAA requirements refers to the HIPAA Privacy Rule, which
protects the privacy of individually identifiable health information; the
HIPAA Security Rule, which sets national standards for the security of
electronic protected health information; and the confidentiality provisions of
the Patient Safety Rule, which protect identifiable information being used to
analyze patient safety events and improve patient safety.
Litigious society refers to excessively ready to go to law or initiate a lawsuit.
▶ The patient's laboratory report today indicates severe hypokalemia, and
the nurse has notified the physician. Nursing assessment indicates that
heart rhythm is regular. What is the most important nursing intervention for
this patient now?
A) Examine sacral area and patient's heels for skin breakdown due to
potential edema.
B) Establish seizure precautions due to potential muscle twitching, cramps,
and seizures.
C) Institute fall precautions due to potential postural hypotension and weak
leg muscles.
D) Raise bed side rails due to potential decreased level of consciousness
and confusion.. Answer: C
Hypokalemia can cause postural hypotension and bilateral muscle
weakness, especially in the lower extremities. Both of these increase the
risk of falls. Hypokalemia does not cause edema, decreased level of
consciousness, or seizures.
▶ A nurse is assessing clients for fluid and electrolyte imbalances. Which
client is at greatest risk for developing hyponatremia?
A) Client taking digoxin (Lanoxin)
B) Client who is NPO receiving intravenous D5W
,C) Client taking ibuprofen (Motrin)
D) Client taking a sulfonamide antibiotic. Answer: B
D5W contains no electrolytes. Because the client is not taking any food or
fluids by mouth, normal sodium excretion can lead to hyponatremia. The
antibiotic, Motrin, and digoxin will not put a client at risk for hyponatremia.
▶ The nurse accidentally administers 10 mg of morphine intravenously to a
client who had been given another dose of morphine, 5 mg IV, about 30
minutes earlier. What action must the nurse be prepared to take?
A) Assist with intubation.
B) Monitor pain level.
C) Administer oxygen.
D) Administer naloxone (Narcan).. Answer: D
A combined dose of 15 mg of morphine may cause severe respiratory
depression in some clients. Naloxone is an opioid antagonist that can be
used (intravenously) as the first intervention to reverse respiratory
depression due to a morphine overdose. Then administration of oxygen
may be needed if the client's oxygen saturation decreases. Intubation may
occur if the client does not respond to the Narcan, and respiratory
depression becomes a respiratory arrest. Naloxone may be repeated, but
the pain level of the client needs to be monitored because Narcan can
promote withdrawal symptoms.
▶ Which action does the nurse teach a client to reduce the risk for
dehydration?
A) Avoiding the use of glycerin suppositories to manage constipation
B) Maintaining a daily oral intake approximately equal to daily fluid loss
C) Restricting sodium intake to no greater than 4 g/day
D) Maintaining an oral intake of at least 1500 mL/day. Answer: B
Although a fixed oral intake of 1500 mL daily is good, the key to prevention
of dehydration is to match all fluid losses with the same volume for fluid
intake. This is especially true in warm or dry environments, or when
conditions result in greater than usual fluid loss through perspiration or
ventilation.
, ▶ A client is taking furosemide (Lasix) and becomes confused. Which
potassium level does the nurse correlate with this condition?
A) 2.9 mEq/L
B) 5.0 mEq/L
C) 6.0 mEq/L
D) 3.8 mEq/L. Answer: A
Hypokalemia decreases cerebral function and is manifested by lethargy,
confusion, inability to perform problem-solving tasks, disorientation, and
coma. Normal potassium levels are 3.5 to 5.0 mEq/L. At 2.9 mEq/L,
potassium is too low, and this could lead to neurologic manifestations.
▶ The most appropriate measure for a nurse to use in assessing core body
temperature when there are suspected problems with thermoregulation is
a(n)
A) rectal thermometer.
B) tympanic membrane sensor.
C) temporal thermometer scan.
D) oral thermometer.. Answer: A
The most reliable means available for assessing core temperature is a
rectal temperature, which is considered the standard of practice. An oral
temperature is a common measure but not the most reliable. A temporal
thermometer scan has some limitations and is not the standard. The
tympanic membrane sensor could be used as a second source for
temperature assessment.
▶ A client presents to the emergency department after prolonged exposure
to the cold. The client is shivering, has slurred speech, and is slow to
respond to questions. Which intervention will the nurse prepare for this
client FIRST?
A) Continuous arteriovenous rewarming
B) Dry clothing and warm blankets
C) Peritoneal lavage with warmed normal saline
D) Administration of warmed IV fluids. Answer: B
Mild hypothermia is manifested by shivering, slurred speech, poor muscular
coordination, and impaired cognitive abilities. Mild hypothermia may be
COMPLETE QUESTIONS WITH ANSWERS
▶ Before surgery, the nurse observes the client listening to music on the
radio. Based on this observation, the nurse may try which
nonpharmacologic intervention for pain relief in the postoperative setting?
A) Cutaneous skin stimulation
B) Imagery
C) Radiofrequency ablation
D) Hypnosis. Answer: B
Imagery is a form of distraction in which the client is encouraged to
visualize about some pleasant or desirable feeling, sensation, or event.
Behaviors that are helpful in assessing a client's capacity for imagery
include being able to listen to music or other auditory stimuli.
▶ What interrelated constructs facilitate a nurse to become culturally
competent?
A) Cultural desire, self-awareness, cultural knowledge, and cultural skill
B) Cultural desire, self-awareness, cultural knowledge, and cultural
diversity
C) Cultural desire, self-awareness, cultural knowledge, and cultural identity
D) Cultural diversity, self-awareness, cultural skill, and cultural knowledge.
Answer: A
The process of cultural competence consists of four interrelated constructs:
cultural desire, self-awareness, cultural knowledge, and cultural skill.
Cultural diversity in the context of health care refers to achieving the
highest level of health care for all people by addressing societal inequalities
and historical and contemporary injustices. Cultural identity is the norms,
values, beliefs, and behaviors of a culture learned through families and
group members.
▶ The emphasis on understanding cultural influence on health care is
important because of:
,A) disability entitlements.
B) HIPAA requirements.
C) litigious society.
D) increasing global diversity.. Answer: D
Culture is an essential aspect of health care because of increasing
diversity. Disability entitlements refer to defined benefits for eligible mental
or physically disabled beneficiaries in relation to housing, employment, and
health care. HIPAA requirements refers to the HIPAA Privacy Rule, which
protects the privacy of individually identifiable health information; the
HIPAA Security Rule, which sets national standards for the security of
electronic protected health information; and the confidentiality provisions of
the Patient Safety Rule, which protect identifiable information being used to
analyze patient safety events and improve patient safety.
Litigious society refers to excessively ready to go to law or initiate a lawsuit.
▶ The patient's laboratory report today indicates severe hypokalemia, and
the nurse has notified the physician. Nursing assessment indicates that
heart rhythm is regular. What is the most important nursing intervention for
this patient now?
A) Examine sacral area and patient's heels for skin breakdown due to
potential edema.
B) Establish seizure precautions due to potential muscle twitching, cramps,
and seizures.
C) Institute fall precautions due to potential postural hypotension and weak
leg muscles.
D) Raise bed side rails due to potential decreased level of consciousness
and confusion.. Answer: C
Hypokalemia can cause postural hypotension and bilateral muscle
weakness, especially in the lower extremities. Both of these increase the
risk of falls. Hypokalemia does not cause edema, decreased level of
consciousness, or seizures.
▶ A nurse is assessing clients for fluid and electrolyte imbalances. Which
client is at greatest risk for developing hyponatremia?
A) Client taking digoxin (Lanoxin)
B) Client who is NPO receiving intravenous D5W
,C) Client taking ibuprofen (Motrin)
D) Client taking a sulfonamide antibiotic. Answer: B
D5W contains no electrolytes. Because the client is not taking any food or
fluids by mouth, normal sodium excretion can lead to hyponatremia. The
antibiotic, Motrin, and digoxin will not put a client at risk for hyponatremia.
▶ The nurse accidentally administers 10 mg of morphine intravenously to a
client who had been given another dose of morphine, 5 mg IV, about 30
minutes earlier. What action must the nurse be prepared to take?
A) Assist with intubation.
B) Monitor pain level.
C) Administer oxygen.
D) Administer naloxone (Narcan).. Answer: D
A combined dose of 15 mg of morphine may cause severe respiratory
depression in some clients. Naloxone is an opioid antagonist that can be
used (intravenously) as the first intervention to reverse respiratory
depression due to a morphine overdose. Then administration of oxygen
may be needed if the client's oxygen saturation decreases. Intubation may
occur if the client does not respond to the Narcan, and respiratory
depression becomes a respiratory arrest. Naloxone may be repeated, but
the pain level of the client needs to be monitored because Narcan can
promote withdrawal symptoms.
▶ Which action does the nurse teach a client to reduce the risk for
dehydration?
A) Avoiding the use of glycerin suppositories to manage constipation
B) Maintaining a daily oral intake approximately equal to daily fluid loss
C) Restricting sodium intake to no greater than 4 g/day
D) Maintaining an oral intake of at least 1500 mL/day. Answer: B
Although a fixed oral intake of 1500 mL daily is good, the key to prevention
of dehydration is to match all fluid losses with the same volume for fluid
intake. This is especially true in warm or dry environments, or when
conditions result in greater than usual fluid loss through perspiration or
ventilation.
, ▶ A client is taking furosemide (Lasix) and becomes confused. Which
potassium level does the nurse correlate with this condition?
A) 2.9 mEq/L
B) 5.0 mEq/L
C) 6.0 mEq/L
D) 3.8 mEq/L. Answer: A
Hypokalemia decreases cerebral function and is manifested by lethargy,
confusion, inability to perform problem-solving tasks, disorientation, and
coma. Normal potassium levels are 3.5 to 5.0 mEq/L. At 2.9 mEq/L,
potassium is too low, and this could lead to neurologic manifestations.
▶ The most appropriate measure for a nurse to use in assessing core body
temperature when there are suspected problems with thermoregulation is
a(n)
A) rectal thermometer.
B) tympanic membrane sensor.
C) temporal thermometer scan.
D) oral thermometer.. Answer: A
The most reliable means available for assessing core temperature is a
rectal temperature, which is considered the standard of practice. An oral
temperature is a common measure but not the most reliable. A temporal
thermometer scan has some limitations and is not the standard. The
tympanic membrane sensor could be used as a second source for
temperature assessment.
▶ A client presents to the emergency department after prolonged exposure
to the cold. The client is shivering, has slurred speech, and is slow to
respond to questions. Which intervention will the nurse prepare for this
client FIRST?
A) Continuous arteriovenous rewarming
B) Dry clothing and warm blankets
C) Peritoneal lavage with warmed normal saline
D) Administration of warmed IV fluids. Answer: B
Mild hypothermia is manifested by shivering, slurred speech, poor muscular
coordination, and impaired cognitive abilities. Mild hypothermia may be
