Verified and Provided
with A+ Graded
Answers |Latest
Updated 2026
,A nurse is caring for a client who has not voided for several hours. When percussing
the client's bladder to assess for distention, the nurse should expect to hear which of
these sounds?
-Tympany
-Hyperresonance
-Dullness
-Resonance.
dullness
A nurse is preparing to change a client's sterile dressing. Which actions by the nurse, if
observed, would contaminate the sterile field?
-The nurse opens the sterile dressing tray without touching the inner surface of the
wrapper
-The nurse removes the indicator tape from a package of sterile 4x4's and opens the first
flap with a motion away from the nurse's body
-The nurse spills sterile saline on the sterile field
-The nurse handles the inside of the sterile gown when putting it on.
The nurse spills sterile saline on the sterile field.
A nurse removes an indwelling urethral (Foley) catheter from a client. Six hours later, the
nurse notes that the client has not voided. Which of these actions should the nurse take?
-Apply pressure to the client's suprapubic area
-Obtain an order to recatheterize the client
-Run the tap water while the client is on the toilet
-Tell the client to call whenever there is the urge to void.
Run the tap water while the client is on the toilet.
,A client who is jaundiced reports itching. To relieve the itching, which of these measures
would be most helpful?
-Having the client wear clothing made from synthetic fibers
-Giving the client sponge baths with tepid water several times a day
-Rubbing the client's skin with diluted alcohol
-Exposing the client to the direct rays of the sun.
Giving the client sponge baths with tepid water several times a day.
A nurse is assigned to care for a client who has pulmonary tuberculosis and is coughing.
Which of these protective devices should the nurse put on before entering the client's
room to give an oral medication?
-Mask
-Gloves
-Gown
-Eye shield.
mask
A nurse is instructing a client on how to limit saturated fat intake and increase intake of
foods high in polyunsaturated fat. Which of these fats is highest in polyunsaturated fatty
acids?
-Corn oil
-Vegetable shortening
-Olive oil
-Butter.
corn oil
, A nurse obtains a tympanic electronic thermometer reading of 97F (36.1C) on a client
who is flushed and warm to touch. Which of these actions should the nurse take next?
-Return the electronic unit and connect it to the source to recharge the batteries
-Report the reading to the nurse-in-charge
-Recheck the temperature with another thermometer
-Recheck the temperature in a half-hour.
Recheck the temperature with another thermometer
A nurse who is caring for a client with a nursing diagnosis of impaired physical mobility
repositions the client every two hours. Which of these steps of the nursing process does
the nurse demonstrate?
-Planning
-Assessing
-Analyzing
-Implementing.
implementing
Before nurses obtain information about a client's sexual health status as part of
the admission assessment, it would be most important for nurses to assess their
own
-interviewing techniques
-gender role identity
-knowledge of sexual reproduction
-personal attitudes about sexuality.
personal attitudes about sexuality
A nurse is caring for a client whose laboratory reports indicate hypernatremia. Which of
these measures should be included in this client's plan of care?
-Inserting an indwelling catheter
-Increasing fluid intake
-Elevating the lower extremities
-Monitoring respiratory rate.
increasing fluid intake