·A nurse is caring for a client who has bipolar disorder and is experiencing acute mania.The nurse obtained a
verbal prescription for restraints. Which of the following should the actions the nurse take?
A. Request a renewal of the prescription every 8 hr.
B. Check the client's peripheral pulse rate every 30 min
C. Obtain a prescription for restraint within 4 hr.
D. Document the client's condition every 15 minutes
RN Comprehensive Predictor 2023 CLOSE
Question:1 of 180 Time Remaining: 03:58 20 PAUSE
Pause Remaining:00:05:00
Anurse is caring for a cient. Complete the following sentence by using the lists of options.
..·.........
rhbe! Dshih 2 Deth43 Dhbe Ergets
Select and will need to be monitored for
Nurses' Notes Select
The nurse understands that the patient has likely developed
0800
A client who has bipolar disorder is admitted to the
inpatient psychiatric unit.During the morning
assessment, the client
reports blurred vision and an increase in urine output. It is
noted that the client is having clonic jerking of upper
extremities.Provider notified and laboratory tests ordered.Skin
is warm and dry without rash.
Full acreen mode is an affect during your prectored teeting
Please Nohe Atfenutng to eet oet of fuil soreen cushe or prensing the excape burtee wil reral in an aler message
sent to the proctor and may reeell ins the Proninaion of the 80001
Conymght C J02I Assetiment Technotogies matnite. LL.C Al rights reearved.
·A nursing planning care for a school-age child who is 4 hr postoperative following perforated
appendicitis.Which of the following actions should the nurse include in the plan of care?
a. Offer small amounts of clear liquids 6 hr following surgery (assess for gag reflex
, first)
b. Give cromolyn nebulizer solution every 6 hr (for asthma)
C. Apply a warm compress to the operative site every 4 hr
d. Administer analgesics on a scheduled basis for the first 24 hr
·A nurse is receiving change-of-shift report for a group of clients. Which of the following clients
should the nurse plan to assess first?
a. A client who has sinus arrhythmia and is receiving cardiac monitoring
b. A client who has diabetes mellitus and a hemoglobin A1C of 6.8%
c. A client who has epidural analgesia and weakness in the lower extremities
d. A client who has a hp fracture and a new onset of tachypnea
·A nurse is preparing to apply a transdermal nicotine patch for a client. Which of the following actions should the
nurse tak e?
a.Shave hairy areas of skin prior to application (apply to hairless, clean & dry areas to promote
absorption; avoid oily or broken skin)
b. Wear gloves to apply the patch to the client's skin
c. Apply the patch within 1 hr of removing it from the protective pouch
(apply immediately)
d. Remove the previous patch and place it in a tissue (fold patch in half with sticky sides pressed together)
· A nurse has just received change-of-shift report for four clients.
Which of the following clients should the nurse assess first?
,a. A client who was just given a glass of orange juice for a low blood glucose level
b. A client who is schedule for a procedure in 1 hr (can wait)
C.A client who has 100 mL fluid remaining in his IV bag (can wait)
d. A client who received a pain medication 30 min ago for postoperative pain
· A nurse is caring for a client who is receiving intermittent enteral tube feedings.Which
of the following places the client at risk for aspiration?
a. A history of gastroesophageal reflux disease
b. Receiving a high osmolarity formula
C.Sitting in a high-Fowler's position during the feeding
d. A residual of 65 mL 1hr postprandial
·A nurse is reviewing the laboratory results for a client who has Cushing's disease. The nurse shouild
expect the client to have an increase in which of the following laboratory values? a.Serum glucose level-
increased
Serum calcium level-decreased
C. Lymphocyte count-decreased immune system.
d. Serum potassium level-decreased
. 8. A nurse is caring for a client who has severe preeclampsia and is receiving magnesium sulfate
intravenously.The nurse discontinues the magnesium sulfate after the client displaces toxicity.Which of
the following actions should the nurse take?
a. Position the client supine
b.Prepare an IV bolus of dextrose 5% in water
C. Administer methylergonovine IM
d. Administer calcium gluconate IV
Calcium gluconate is given for magnesium sulfate toxicity. Always have an injectable form of
calcium gluconate available when administering magnesium sulfate by IV.
, 9. A charge nurse is teaching new staff members about factors that increase a client's risk to become
violent. Which of the following risk factors should the nurse include as the best predictor of future
violence? a. Experiencing delusions b. Male gender
C. Previous violent behavior
d. A history of being in prison
Risk factors also include: past history of aggression, poor impulse control,and violence.
Comorbidity that leads to acts of violence (psychotic delusions, command hallucinations,violent angry
reactions with cognitive disorders). Individual Assessment for Violence
verbal prescription for restraints. Which of the following should the actions the nurse take?
A. Request a renewal of the prescription every 8 hr.
B. Check the client's peripheral pulse rate every 30 min
C. Obtain a prescription for restraint within 4 hr.
D. Document the client's condition every 15 minutes
RN Comprehensive Predictor 2023 CLOSE
Question:1 of 180 Time Remaining: 03:58 20 PAUSE
Pause Remaining:00:05:00
Anurse is caring for a cient. Complete the following sentence by using the lists of options.
..·.........
rhbe! Dshih 2 Deth43 Dhbe Ergets
Select and will need to be monitored for
Nurses' Notes Select
The nurse understands that the patient has likely developed
0800
A client who has bipolar disorder is admitted to the
inpatient psychiatric unit.During the morning
assessment, the client
reports blurred vision and an increase in urine output. It is
noted that the client is having clonic jerking of upper
extremities.Provider notified and laboratory tests ordered.Skin
is warm and dry without rash.
Full acreen mode is an affect during your prectored teeting
Please Nohe Atfenutng to eet oet of fuil soreen cushe or prensing the excape burtee wil reral in an aler message
sent to the proctor and may reeell ins the Proninaion of the 80001
Conymght C J02I Assetiment Technotogies matnite. LL.C Al rights reearved.
·A nursing planning care for a school-age child who is 4 hr postoperative following perforated
appendicitis.Which of the following actions should the nurse include in the plan of care?
a. Offer small amounts of clear liquids 6 hr following surgery (assess for gag reflex
, first)
b. Give cromolyn nebulizer solution every 6 hr (for asthma)
C. Apply a warm compress to the operative site every 4 hr
d. Administer analgesics on a scheduled basis for the first 24 hr
·A nurse is receiving change-of-shift report for a group of clients. Which of the following clients
should the nurse plan to assess first?
a. A client who has sinus arrhythmia and is receiving cardiac monitoring
b. A client who has diabetes mellitus and a hemoglobin A1C of 6.8%
c. A client who has epidural analgesia and weakness in the lower extremities
d. A client who has a hp fracture and a new onset of tachypnea
·A nurse is preparing to apply a transdermal nicotine patch for a client. Which of the following actions should the
nurse tak e?
a.Shave hairy areas of skin prior to application (apply to hairless, clean & dry areas to promote
absorption; avoid oily or broken skin)
b. Wear gloves to apply the patch to the client's skin
c. Apply the patch within 1 hr of removing it from the protective pouch
(apply immediately)
d. Remove the previous patch and place it in a tissue (fold patch in half with sticky sides pressed together)
· A nurse has just received change-of-shift report for four clients.
Which of the following clients should the nurse assess first?
,a. A client who was just given a glass of orange juice for a low blood glucose level
b. A client who is schedule for a procedure in 1 hr (can wait)
C.A client who has 100 mL fluid remaining in his IV bag (can wait)
d. A client who received a pain medication 30 min ago for postoperative pain
· A nurse is caring for a client who is receiving intermittent enteral tube feedings.Which
of the following places the client at risk for aspiration?
a. A history of gastroesophageal reflux disease
b. Receiving a high osmolarity formula
C.Sitting in a high-Fowler's position during the feeding
d. A residual of 65 mL 1hr postprandial
·A nurse is reviewing the laboratory results for a client who has Cushing's disease. The nurse shouild
expect the client to have an increase in which of the following laboratory values? a.Serum glucose level-
increased
Serum calcium level-decreased
C. Lymphocyte count-decreased immune system.
d. Serum potassium level-decreased
. 8. A nurse is caring for a client who has severe preeclampsia and is receiving magnesium sulfate
intravenously.The nurse discontinues the magnesium sulfate after the client displaces toxicity.Which of
the following actions should the nurse take?
a. Position the client supine
b.Prepare an IV bolus of dextrose 5% in water
C. Administer methylergonovine IM
d. Administer calcium gluconate IV
Calcium gluconate is given for magnesium sulfate toxicity. Always have an injectable form of
calcium gluconate available when administering magnesium sulfate by IV.
, 9. A charge nurse is teaching new staff members about factors that increase a client's risk to become
violent. Which of the following risk factors should the nurse include as the best predictor of future
violence? a. Experiencing delusions b. Male gender
C. Previous violent behavior
d. A history of being in prison
Risk factors also include: past history of aggression, poor impulse control,and violence.
Comorbidity that leads to acts of violence (psychotic delusions, command hallucinations,violent angry
reactions with cognitive disorders). Individual Assessment for Violence
