South College NSG 3113 ATI PRACTICE A QUIZ 1020 || 100%
Correct Answers.
A NURSE IS PROVIDING HYGIENE CARE FOR A CLIENT WHO IS IMMOBILE WHICH
OF THE FOLLOWING ACTIONS SHOULD THE NURSE TAKE? (Select all that Apply)
A: Check for personal items when changing the bed linens
B: Place a Clean Gown on the strongest arm first
C: Keep the bath water temperature between 43.3 *C (110*F) and 46.1 *C (115*F)
D: Shave the client's hair in the direction of the hair growth
E: Wash the client's extremities from proximal to distal correct answers A, C, D
A nurse is planning care for an older adult who is at risk for developing pressure ulcers. which of
the following interventions should the nurse use to help maintain the integrity of the client's
skin?
A: Use a transfer device to lift the client up in the bed
B: Apply cornstarch to keep sensitive skin areas dry
C: Massage the skin over the client's bony prominences
D: Elevate the head of the bed no more than 45* correct answers A
A nurse is planning care for a client who has a decreased level of consciousness. The client is
receiving continuous enteral feeding via a gastrostomy tube due to an inability to swallow.
Which of the following is a priority action by the nurse?
A: observe the client's respiratory status
B: Elevate the head of the client's bed 30* to 45*
C: Monitor intake and output every 8 hours
D: Check residual volume every 4 to 6 hours correct answers B
A nurse is caring for a client who is scheduled for an elective surgical procedure . Which of the
following actions should the nurse take regarding informed consent?
, A; obtain the client's consent
B: Witness the Client's signature
C: Explain the risks and benefits of the procedure
D: Explain the procedure to the client if they do not understand correct answers B
A nurse is attending a social event when another guest coughs weakly once, gasps his throat with
his hands, and cannot talk. Which of the following actions should the nurse should take?
A: observe the client before taking further action
B: perform the heimlich maneuver
C: assist the client to the floor and begin mouth to mouth resuscitation
D: Slap the client on the back several times correct answers B
A nurse is caring for a client who has impaired mobility. Which of the following support devices
should the nurse plan to use to prevent the client from developing plantar flexion contractures?
A: trochanter roll
B: Sheepskin Heel Pad
C: Abduction Pillow
D: Foot board correct answers foot board
A nurse is caring for a client who has an electrical burn. With the client's permission, the nurse is
answering questions from the family about his status. Which of the following responses should
the nurse make?
A: He is doing well, although he might be in the hospital for some time
B: he has an electrical burn, he is stable, and we will update you with any changes.
C: He has an electrical burn, which caused coagulation of some tissues
D: he does not appear to have much damage and should be fine soon correct answers B
A nurse is teaching a client's partner about how to obtain a blood pressure reading. Which of the
following actions by the partner indicates a need for further instruction?
Correct Answers.
A NURSE IS PROVIDING HYGIENE CARE FOR A CLIENT WHO IS IMMOBILE WHICH
OF THE FOLLOWING ACTIONS SHOULD THE NURSE TAKE? (Select all that Apply)
A: Check for personal items when changing the bed linens
B: Place a Clean Gown on the strongest arm first
C: Keep the bath water temperature between 43.3 *C (110*F) and 46.1 *C (115*F)
D: Shave the client's hair in the direction of the hair growth
E: Wash the client's extremities from proximal to distal correct answers A, C, D
A nurse is planning care for an older adult who is at risk for developing pressure ulcers. which of
the following interventions should the nurse use to help maintain the integrity of the client's
skin?
A: Use a transfer device to lift the client up in the bed
B: Apply cornstarch to keep sensitive skin areas dry
C: Massage the skin over the client's bony prominences
D: Elevate the head of the bed no more than 45* correct answers A
A nurse is planning care for a client who has a decreased level of consciousness. The client is
receiving continuous enteral feeding via a gastrostomy tube due to an inability to swallow.
Which of the following is a priority action by the nurse?
A: observe the client's respiratory status
B: Elevate the head of the client's bed 30* to 45*
C: Monitor intake and output every 8 hours
D: Check residual volume every 4 to 6 hours correct answers B
A nurse is caring for a client who is scheduled for an elective surgical procedure . Which of the
following actions should the nurse take regarding informed consent?
, A; obtain the client's consent
B: Witness the Client's signature
C: Explain the risks and benefits of the procedure
D: Explain the procedure to the client if they do not understand correct answers B
A nurse is attending a social event when another guest coughs weakly once, gasps his throat with
his hands, and cannot talk. Which of the following actions should the nurse should take?
A: observe the client before taking further action
B: perform the heimlich maneuver
C: assist the client to the floor and begin mouth to mouth resuscitation
D: Slap the client on the back several times correct answers B
A nurse is caring for a client who has impaired mobility. Which of the following support devices
should the nurse plan to use to prevent the client from developing plantar flexion contractures?
A: trochanter roll
B: Sheepskin Heel Pad
C: Abduction Pillow
D: Foot board correct answers foot board
A nurse is caring for a client who has an electrical burn. With the client's permission, the nurse is
answering questions from the family about his status. Which of the following responses should
the nurse make?
A: He is doing well, although he might be in the hospital for some time
B: he has an electrical burn, he is stable, and we will update you with any changes.
C: He has an electrical burn, which caused coagulation of some tissues
D: he does not appear to have much damage and should be fine soon correct answers B
A nurse is teaching a client's partner about how to obtain a blood pressure reading. Which of the
following actions by the partner indicates a need for further instruction?
